Trial Outcomes & Findings for Minnesota Community-Based Cognitive Training in Early Psychosis (NCT NCT03079024)

Results Overview

A composite T-score of: 1. Symbol Coding from the Brief Assessment of Cognition in Schizophrenia (BACS): Symbol Coding. Timed paper-and-pencil test in which respondent uses a key to write digits that correspond to nonsense symbols. 2. Category Fluency: Animal Naming: Oral test in which respondent names as many animals as she/he can in 1 minute. 3. Trail Making Test: Part A: Timed paper-and-pencil test in which respondent draws a line to connect consecutively numbered circles placed irregularly on a sheet of paper. The composite T-score is the average T-score across the 3 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T- score of 50 indicates the population mean (average) with a standard deviation of 10\.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

45 participants

Primary outcome timeframe

baseline

Results posted on

2025-01-23

Participant Flow

Participant milestones

Participant milestones
Measure	Targeted Cognitive Training (TCT) Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	General Cognitive Exercises (GCE) Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Overall Study STARTED	16	17	12
Overall Study COMPLETED	13	14	9
Overall Study NOT COMPLETED	3	3	3

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Minnesota Community-Based Cognitive Training in Early Psychosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Total n=45 Participants Total of all reporting groups
Age, Continuous	20.88 years STANDARD_DEVIATION 3.22 • n=5 Participants	20.59 years STANDARD_DEVIATION 4.37 • n=7 Participants	22 years STANDARD_DEVIATION 3.38 • n=5 Participants	21.07 years STANDARD_DEVIATION 3.70 • n=4 Participants
Sex: Female, Male Female	3 Participants n=5 Participants	1 Participants n=7 Participants	4 Participants n=5 Participants	8 Participants n=4 Participants
Sex: Female, Male Male	13 Participants n=5 Participants	16 Participants n=7 Participants	8 Participants n=5 Participants	37 Participants n=4 Participants
Race (NIH/OMB) American Indian or Alaska Native	1 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	1 Participants n=7 Participants	2 Participants n=5 Participants	3 Participants n=4 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants
Race (NIH/OMB) Black or African American	3 Participants n=5 Participants	2 Participants n=7 Participants	1 Participants n=5 Participants	6 Participants n=4 Participants
Race (NIH/OMB) White	10 Participants n=5 Participants	12 Participants n=7 Participants	7 Participants n=5 Participants	29 Participants n=4 Participants
Race (NIH/OMB) More than one race	2 Participants n=5 Participants	1 Participants n=7 Participants	1 Participants n=5 Participants	4 Participants n=4 Participants
Race (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	1 Participants n=7 Participants	1 Participants n=5 Participants	2 Participants n=4 Participants

PRIMARY outcome

Timeframe: baseline

A composite T-score of: 1. Symbol Coding from the Brief Assessment of Cognition in Schizophrenia (BACS): Symbol Coding. Timed paper-and-pencil test in which respondent uses a key to write digits that correspond to nonsense symbols. 2. Category Fluency: Animal Naming: Oral test in which respondent names as many animals as she/he can in 1 minute. 3. Trail Making Test: Part A: Timed paper-and-pencil test in which respondent draws a line to connect consecutively numbered circles placed irregularly on a sheet of paper. The composite T-score is the average T-score across the 3 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T- score of 50 indicates the population mean (average) with a standard deviation of 10\.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=11 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Speed of Processing From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	41.2 T-score Standard Deviation 12.74	24.82 T-score Standard Deviation 14.5	41.75 T-score Standard Deviation 8.75

PRIMARY outcome

Timeframe: 6 weeks

A composite T-score of: 1. Symbol Coding from the Brief Assessment of Cognition in Schizophrenia (BACS): Symbol Coding. Timed paper-and-pencil test in which respondent uses a key to write digits that correspond to nonsense symbols. 2. Category Fluency: Animal Naming: Oral test in which respondent names as many animals as she/he can in 1 minute. 3. Trail Making Test: Part A: Timed paper-and-pencil test in which respondent draws a line to connect consecutively numbered circles placed irregularly on a sheet of paper. The composite T-score is the average T-score across the 3 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T- score of 50 indicates the population mean (average) with a standard deviation of 10\.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=7 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Speed of Processing From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	39.22 T-score Standard Deviation 12.43	41.57 T-score Standard Deviation 14.01	49.5 T-score Standard Deviation 13.96

PRIMARY outcome

Timeframe: 6 months followup

A composite T-score of: 1. Symbol Coding from the Brief Assessment of Cognition in Schizophrenia (BACS): Symbol Coding. Timed paper-and-pencil test in which respondent uses a key to write digits that correspond to nonsense symbols. 2. Category Fluency: Animal Naming: Oral test in which respondent names as many animals as she/he can in 1 minute. 3. Trail Making Test: Part A: Timed paper-and-pencil test in which respondent draws a line to connect consecutively numbered circles placed irregularly on a sheet of paper. The composite T-score is the average T-score across the 3 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T- score of 50 indicates the population mean (average) with a standard deviation of 10\.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Speed of Processing From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	40.56 T-score Standard Deviation 10.62	51.5 T-score Standard Deviation 16.26	48.4 T-score Standard Deviation 13.13

PRIMARY outcome

Timeframe: baseline

Continuous Performance Test-Identical Pairs (CPT-IP): A computer- administered measure of sustained attention in which respondent presses a response button to consecutive matching numbers. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Attention From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	35.2 T-score Standard Deviation 9.17	34.5 T-score Standard Deviation 8.92	37.38 T-score Standard Deviation 10.83

PRIMARY outcome

Timeframe: 6 weeks

Continuous Performance Test-Identical Pairs (CPT-IP): A computer- administered measure of sustained attention in which respondent presses a response button to consecutive matching numbers. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=6 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Attention From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	36.89 T-score Standard Deviation 11.17	41.67 T-score Standard Deviation 7.37	42.4 T-score Standard Deviation 9.52

PRIMARY outcome

Timeframe: 6 months followup

Continuous Performance Test-Identical Pairs (CPT-IP): A computer- administered measure of sustained attention in which respondent presses a response button to consecutive matching numbers. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=8 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Attention From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	37.5 T-score Standard Deviation 8.91	39.5 T-score Standard Deviation 3.54	40.6 T-score Standard Deviation 11.3

PRIMARY outcome

Timeframe: Basline

Verbal and Visual Working Memory: A composite score of the Letter- Number Span test and the Spatial Span test from the Wechsler Memory Scale®-3rd Ed. (WMS®-III). Letter-Number Span: An orally administered test in which respondent mentally reorders strings of number and letters and repeats them to administrator. Spatial Span: Using a board on which 10 cubes are irregularly spaced, respondent taps cubes in same (or reverse) sequence as test administrator. The composite T-score is the average T-score across the 2 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Working Memory From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	43.88 T-score Standard Deviation 11.11	39.17 T-score Standard Deviation 8.5	44.13 T-score Standard Deviation 10.4

PRIMARY outcome

Timeframe: 6 weeks

Verbal and Visual Working Memory: A composite score of the Letter- Number Span test and the Spatial Span test from the Wechsler Memory Scale®-3rd Ed. (WMS®-III). Letter-Number Span: An orally administered test in which respondent mentally reorders strings of number and letters and repeats them to administrator. Spatial Span: Using a board on which 10 cubes are irregularly spaced, respondent taps cubes in same (or reverse) sequence as test administrator. The composite T-score is the average T-score across the 2 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=9 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Working Memory From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	43.29 T-score Standard Deviation 12.64	43.8 T-score Standard Deviation 4.49	43.5 T-score Standard Deviation 12.06

PRIMARY outcome

Timeframe: 6 months followup

Verbal and Visual Working Memory: A composite score of the Letter- Number Span test and the Spatial Span test from the Wechsler Memory Scale®-3rd Ed. (WMS®-III). Letter-Number Span: An orally administered test in which respondent mentally reorders strings of number and letters and repeats them to administrator. Spatial Span: Using a board on which 10 cubes are irregularly spaced, respondent taps cubes in same (or reverse) sequence as test administrator. The composite T-score is the average T-score across the 2 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Working Memory From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	41.91 T-score Standard Deviation 11.92	43.8 T-score Standard Deviation 4.49	43.75 T-score Standard Deviation 11.05

PRIMARY outcome

Timeframe: Baseline

Hopkins Verbal Learning Test-Revised (HVLT-R): An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after each of three learning trials. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42.71 T-score Standard Deviation 9.36	36.83 T-score Standard Deviation 7.85	43.06 T-score Standard Deviation 9.17

PRIMARY outcome

Timeframe: 6 weeks

Hopkins Verbal Learning Test-Revised (HVLT-R): An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after each of three learning trials. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=9 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	43.57 T-score Standard Deviation 9.08	40.22 T-score Standard Deviation 8.57	42.6 T-score Standard Deviation 7.26

PRIMARY outcome

Timeframe: 6 months followup

Hopkins Verbal Learning Test-Revised (HVLT-R): An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after each of three learning trials. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42.73 T-score Standard Deviation 8.38	46.2 T-score Standard Deviation 14.32	43.67 T-score Standard Deviation 10.25

PRIMARY outcome

Timeframe: baseline

Brief Visuospatial Memory Test-Revised (BVMT-RTM): A test that involves reproducing six geometric figures from memory. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42.53 T-score Standard Deviation 6.82	36.6 T-score Standard Deviation 8.66	43.63 T-score Standard Deviation 12.25

PRIMARY outcome

Timeframe: 6 weeks

Brief Visuospatial Memory Test-Revised (BVMT-RTM): A test that involves reproducing six geometric figures from memory. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=7 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	41.33 T-score Standard Deviation 8.43	43.14 T-score Standard Deviation 10.99	42.7 T-score Standard Deviation 13.65

PRIMARY outcome

Timeframe: 6 months followup

Brief Visuospatial Memory Test-Revised (BVMT-RTM): A test that involves reproducing six geometric figures from memory. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Learning From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42.89 T-score Standard Deviation 7.41	47 T-score Standard Deviation 15.56	44.4 T-score Standard Deviation 14.34

PRIMARY outcome

Timeframe: baseline

Neuropsychological Assessment Battery® (NAB®): Mazes: Seven timed paper-and-pencil mazes of increasing difficulty that measure foresight and planning. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Problem Solving From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	38.67 T-score Standard Deviation 8.8	36 T-score Standard Deviation 13.93	40.06 T-score Standard Deviation 10.81

PRIMARY outcome

Timeframe: 6 weeks

Neuropsychological Assessment Battery® (NAB®): Mazes: Seven timed paper-and-pencil mazes of increasing difficulty that measure foresight and planning. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=7 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Problem Solving From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42 T-score Standard Deviation 9.8	39 T-score Standard Deviation 11.37	46.4 T-score Standard Deviation 11.34

PRIMARY outcome

Timeframe: 6 months followup

Neuropsychological Assessment Battery® (NAB®): Mazes: Seven timed paper-and-pencil mazes of increasing difficulty that measure foresight and planning. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Problem Solving From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	42.11 T-score Standard Deviation 10.01	44.5 T-score Standard Deviation 20.51	49.3 T-score Standard Deviation 9.92

PRIMARY outcome

Timeframe: baseline

Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT™ ): Managing Emotions: Paper-and-pencil multiple-choice test that assesses how people manage their emotions. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	44.24 T-score Standard Deviation 9.83	45.58 T-score Standard Deviation 11.89	42.75 T-score Standard Deviation 10.27

PRIMARY outcome

Timeframe: 6 weeks

Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT™ ): Managing Emotions: Paper-and-pencil multiple-choice test that assesses how people manage their emotions. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=9 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	41.93 T-score Standard Deviation 9.57	47.44 T-score Standard Deviation 11.68	46.4 T-score Standard Deviation 12.19

PRIMARY outcome

Timeframe: 6 months followup

Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT™ ): Managing Emotions: Paper-and-pencil multiple-choice test that assesses how people manage their emotions. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	44.73 T-score Standard Deviation 7.86	52.6 T-score Standard Deviation 12.18	43.75 T-score Standard Deviation 9.21

PRIMARY outcome

Timeframe: baseline

A composite score of the 7 scores listed above: Speed of Processing, Attention, Working Memory, Verbal Learning, Visual Learning, Problem Solving, and Social Cognition. The composite T-score is the average T-score across the 7 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Global Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	35.4 T-score Standard Deviation 11.56	29.6 T-score Standard Deviation 10.59	36.75 T-score Standard Deviation 11.41

PRIMARY outcome

Timeframe: 6 weeks

A composite score of the 7 scores listed above: Speed of Processing, Attention, Working Memory, Verbal Learning, Visual Learning, Problem Solving, and Social Cognition. The composite T-score is the average T-score across the 7 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=6 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Global Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	33.78 T-score Standard Deviation 11.99	37.5 T-score Standard Deviation 10.95	41.5 T-score Standard Deviation 12.96

PRIMARY outcome

Timeframe: 6 months followup

A composite score of the 7 scores listed above: Speed of Processing, Attention, Working Memory, Verbal Learning, Visual Learning, Problem Solving, and Social Cognition. The composite T-score is the average T-score across the 7 measures. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=8 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Global Cognition From the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)	39.63 T-score Standard Deviation 8.37	45 T-score Standard Deviation 19.8	41.6 T-score Standard Deviation 14.82

PRIMARY outcome

Timeframe: baseline

Emotion Recognition: Participants are shown a series of 40 faces, one at a time, and asked to determine what emotion the face is showing for each trial. There are 5 answer choices: happy, sad, anger, fear and no emotion. Scores (i.e. correct responses) range from 0-40 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotion Recognition From the University of Pennsylvania Computerized Neurobehavioral Test Battery	31.50 Total correct responses Standard Deviation 3.7	32.5 Total correct responses Standard Deviation 2.07	32.56 Total correct responses Standard Deviation 4.05

PRIMARY outcome

Timeframe: Baseline

Emotional Prosody Identification: Participants are presented a series of 80 audio clips played one at a time, and asked to determine what emotion the audio clip portrayed. There are 5 answer choices: Happy, Sad, Anger, Fearful and No Emotion. Scores (i.e. correct responses) range from 0-80 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotional Prosody Identification From the University of Pennsylvania Computerized Neurobehavioral Test Battery Neurobehavioral Test Battery	39.64 Total correct responses Standard Deviation 8.83	37.8 Total correct responses Standard Deviation 11.3	37.94 Total correct responses Standard Deviation 6.41

PRIMARY outcome

Timeframe: 6 weeks

Emotional Prosody Identification: Participants are presented a series of 80 audio clips played one at a time, and asked to determine what emotion the audio clip portrayed. There are 5 answer choices: Happy, Sad, Anger, Fearful and No Emotion. Scores (i.e. correct responses) range from 0-80 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=6 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=8 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotional Prosody Identification From the University of Pennsylvania Computerized Neurobehavioral Test Battery	40.89 Total correct responses Standard Deviation 6.85	41.67 Total correct responses Standard Deviation 5.2	44.63 Total correct responses Standard Deviation 3.96

PRIMARY outcome

Timeframe: 6 weeks

Emotion Recognition: Participants are shown a series of 40 faces, one at a time, and asked to determine what emotion the face is showing for each trial. There are 5 answer choices: happy, sad, anger, fear and no emotion. Scores (i.e. correct responses) range from 0-40 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=7 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=6 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=8 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotion Recognition From the University of Pennsylvania Computerized Neurobehavioral Test Battery	32.29 Total correct responses Standard Deviation 2.75	33.67 Total correct responses Standard Deviation 3.33	34.88 Total correct responses Standard Deviation 3.32

PRIMARY outcome

Timeframe: 6 months

Emotion Recognition: Participants are shown a series of 40 faces, one at a time, and asked to determine what emotion the face is showing for each trial. There are 5 answer choices: happy, sad, anger, fear and no emotion. Scores (i.e. correct responses) range from 0-40 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=7 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotion Recognition From the University of Pennsylvania Computerized Neurobehavioral Test Battery	32.71 Total correct responses Standard Deviation 2.21	33.5 Total correct responses Standard Deviation 2.12	34.9 Total correct responses Standard Deviation 1.79

PRIMARY outcome

Timeframe: 6 months

Emotional Prosody Identification: Participants are presented a series of 80 audio clips played one at a time, and asked to determine what emotion the audio clip portrayed. There are 5 answer choices: Happy, Sad, Anger, Fearful and No Emotion. Scores (i.e. correct responses) range from 0-80 with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=7 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Emotional Prosody Identification From the University of Pennsylvania Computerized Neurobehavioral Test Battery	43.29 Total correct responses Standard Deviation 6.24	41 Total correct responses Standard Deviation 1.41	41.1 Total correct responses Standard Deviation 6.23

PRIMARY outcome

Timeframe: Baseline

Faux Pas Test: Brief stories are read to the participant, and the participant is asked if someone in the story made a faux pas. This test assesses the ability to infer other peoples' mental states, thoughts and feelings. Scores (i.e. percent correct) range from 0-100% with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=11 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Faux Pas Test Theory of Mind	89.33 Percent Standard Deviation 7.99	82.78 Percent Standard Deviation 15.08	83.79 Percent Standard Deviation 6.06

PRIMARY outcome

Timeframe: 6 weeks

Faux Pas Test: Brief stories are read to the participant, and the participant is asked if someone in the story made a faux pas. This test assesses the ability to infer other peoples' mental states, thoughts and feelings. Scores (i.e. percent correct) range from 0-100% with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=9 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=8 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Faux Pas Test Theory of Mind	91.24 Percent Standard Deviation 6.9	81.85 Percent Standard Deviation 13.27	79.38 Percent Standard Deviation 17.3

PRIMARY outcome

Timeframe: 6 months followup

Faux Pas Test: Brief stories are read to the participant, and the participant is asked if someone in the story made a faux pas. This test assesses the ability to infer other peoples' mental states, thoughts and feelings. Scores (i.e. percent correct) range from 0-100% with higher scores corresponding to better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Faux Pas Test Theory of Mind	89.39 Percent Standard Deviation 12	91.67 Percent Standard Deviation 5.89	82.36 Percent Standard Deviation 13.23

PRIMARY outcome

Timeframe: baseline

Functioning: This measure assesses quality of life using subjective questions regarding life satisfaction and objective indicators of social and occupational functioning. Participants are asked questions about social and occupational functioning and intrapsychic foundations (e.g. motivation, sense of purpose, curiosity). The assessor provides ratings on a scale of 0-6 (e.g. absent to adequate). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Quality of Life Scale-Abbreviated (Functioning)	3.75 Mean item score Standard Deviation 1.09	3.72 Mean item score Standard Deviation 1.1	3.69 Mean item score Standard Deviation 1.25

PRIMARY outcome

Timeframe: 6 weeks

Functioning: This measure assesses quality of life using subjective questions regarding life satisfaction and objective indicators of social and occupational functioning. Participants are asked questions about social and occupational functioning and intrapsychic foundations (e.g. motivation, sense of purpose, curiosity). The assessor provides ratings on a scale of 0-6 (e.g. absent to adequate). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Quality of Life Scale-Abbreviated (Functioning)	3.95 Mean item score Standard Deviation 1.1	4.49 Mean item score Standard Deviation 0.79	4.6 Mean item score Standard Deviation 1.06

PRIMARY outcome

Timeframe: 6 months followup

Functioning: This measure assesses quality of life using subjective questions regarding life satisfaction and objective indicators of social and occupational functioning. Participants are asked questions about social and occupational functioning and intrapsychic foundations (e.g. motivation, sense of purpose, curiosity). The assessor provides ratings on a scale of 0-6 (e.g. absent to adequate). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Quality of Life Scale-Abbreviated (Functioning)	3.66 Mean item score Standard Deviation 1.29	4.67 Mean item score Standard Deviation 0.46	4.25 Mean item score Standard Deviation 1.02

PRIMARY outcome

Timeframe: Baseline

Auditory Processing Speed: In Sound Sweeps, participants listen to frequency sweeps-sounds that begin low and rise upward or begin high and fall downward-and identify whether they go up ("weep") or down ("woop"). The sweeps become progressively faster and are separated by shorter interstimulus intervals. The outcome is the threshold reached by the participant which is the fastest interstimulus interval (in milliseconds) at which the participant correctly performed. Scores ranged from 24-1000 milliseconds with lower scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=11 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=7 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Auditory Processing Speed From the Posit Science Sound Sweeps Assessment	124.33 Milliseconds Standard Deviation 70.87	181.64 Milliseconds Standard Deviation 169.41	275.43 Milliseconds Standard Deviation 357.14

PRIMARY outcome

Timeframe: 6 weeks

Auditory Processing Speed: In Sound Sweeps, participants listen to frequency sweeps-sounds that begin low and rise upward or begin high and fall downward-and identify whether they go up ("weep") or down ("woop"). The sweeps become progressively faster and are separated by shorter interstimulus intervals. The outcome is the threshold reached by the participant which is the fastest interstimulus interval (in milliseconds) at which the participant correctly performed. Scores ranged from 24-1000 milliseconds with lower scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=10 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=6 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=4 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Auditory Processing Speed From the Posit Science Sound Sweeps Assessment	76.5 Milliseconds Standard Deviation 39.78	87.67 Milliseconds Standard Deviation 40.71	73 Milliseconds Standard Deviation 21.56

PRIMARY outcome

Timeframe: 6 months followup

Auditory Processing Speed: In Sound Sweeps, participants listen to frequency sweeps-sounds that begin low and rise upward or begin high and fall downward-and identify whether they go up ("weep") or down ("woop"). The sweeps become progressively faster and are separated by shorter interstimulus intervals. The outcome is the threshold reached by the participant which is the fastest interstimulus interval (in milliseconds) at which the participant correctly performed. Scores ranged from 24-1000 milliseconds with lower scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=9 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Auditory Processing Speed From the Posit Science Sound Sweeps Assessment	103.67 Milliseconds Standard Deviation 59.55	99.2 Milliseconds Standard Deviation 89.4	166.44 Milliseconds Standard Deviation 165.09

PRIMARY outcome

Timeframe: Baseline

Reward Sensitivity--Anticipatory Pleasure: This measure assesses pleasure experienced in anticipation of something and consists of 10 items. An example item is: "When something exciting is coming up in my life, I really look forward to it." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater anticipatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=15 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS):Reward Sensitivity--Anticipatory Pleasure	4.1 mean item score Standard Deviation 0.72	4.01 mean item score Standard Deviation 0.6	4.08 mean item score Standard Deviation 0.66

PRIMARY outcome

Timeframe: 6 weeks

Reward Sensitivity--Anticipatory Pleasure: This measure assesses pleasure experienced in anticipation of something and consists of 10 items. An example item is: "When something exciting is coming up in my life, I really look forward to it." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater anticipatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS):Reward Sensitivity--Anticipatory Pleasure	4.09 mean item score Standard Deviation 0.62	4.93 mean item score Standard Deviation 0.7	3.87 mean item score Standard Deviation 0.71

PRIMARY outcome

Timeframe: 6 months followup

Reward Sensitivity--Anticipatory Pleasure: This measure assesses pleasure experienced in anticipation of something and consists of 10 items. An example item is: "When something exciting is coming up in my life, I really look forward to it." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater anticipatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=13 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS):Reward Sensitivity--Anticipatory Pleasure	4.17 mean item score Standard Deviation 0.67	4.42 mean item score Standard Deviation 0.53	4.25 mean item score Standard Deviation 0.79

PRIMARY outcome

Timeframe: Baseline

Reward Sensitivity--Consummatory Pleasure: This measure assesses pleasure experienced in the moment and consists of 8 items. An example item is: "The smell of freshly cut grass is enjoyable to me." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater consummatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS): Reward Sensitivity--Consummatory Pleasure	4.26 Mean Item Score Standard Deviation 1.07	4.47 Mean Item Score Standard Deviation 0.54	4.66 Mean Item Score Standard Deviation 0.72

PRIMARY outcome

Timeframe: 6 weeks

Reward Sensitivity--Consummatory Pleasure: This measure assesses pleasure experienced in the moment and consists of 8 items. An example item is: "The smell of freshly cut grass is enjoyable to me." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater consummatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS): Reward Sensitivity--Consummatory Pleasure	4.7 Mean Item Score Standard Deviation 0.56	4.86 Mean Item Score Standard Deviation 0.47	4.98 Mean Item Score Standard Deviation 0.55

PRIMARY outcome

Timeframe: 6 months followup

Reward Sensitivity--Consummatory Pleasure: This measure assesses pleasure experienced in the moment and consists of 8 items. An example item is: "The smell of freshly cut grass is enjoyable to me." Participants rate how true the statement is for them on a scale of 1 (very false for me) to 6 (very true for me). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater consummatory pleasure.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=13 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Temporal Experience of Pleasures (TEPS): Reward Sensitivity--Consummatory Pleasure	4.78 Mean Item Score Standard Deviation 0.66	4.93 Mean Item Score Standard Deviation 0.56	4.89 Mean Item Score Standard Deviation 0.66

PRIMARY outcome

Timeframe: Baseline

Verbal Memory: Delayed Recall: An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=16 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Memory: Delayed Recall From the Hopkins Verbal Learning Test-Revised Version (HVLT-R)	41.15 T-score Standard Deviation 13.06	32.61 T-score Standard Deviation 14.78	42.55 T-score Standard Deviation 12.54

PRIMARY outcome

Timeframe: 6 weeks

Verbal Memory: Delayed Recall: An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=13 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Memory: Delayed Recall From the Hopkins Verbal Learning Test-Revised Version (HVLT-R)	35.73 T-score Standard Deviation 13.42	37.61 T-score Standard Deviation 19.51	40.69 T-score Standard Deviation 14.18

PRIMARY outcome

Timeframe: 6months followup

Verbal Memory: Delayed Recall: An orally administered test in which a list of 12 words from three taxonomic categories is presented and the respondent is asked to recall as many as possible after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Verbal Memory: Delayed Recall From the Hopkins Verbal Learning Test-Revised Version (HVLT-R)	36.31 T-score Standard Deviation 20.57	38.39 T-score Standard Deviation 22.17	41.32 T-score Standard Deviation 13.87

PRIMARY outcome

Timeframe: baseline

Visual Memory: Delayed Recall: A test that involves reproducing six geometric figures from memory after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Memory: Delayed Recall From the Brief Visuospatial Memory Test-Revised Version (BVMT-R)	46.86 T-score Standard Deviation 13.72	43.09 T-score Standard Deviation 14.62	46.48 T-score Standard Deviation 10.85

PRIMARY outcome

Timeframe: 6 weeks

Visual Memory: Delayed Recall: A test that involves reproducing six geometric figures from memory after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=7 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Memory: Delayed Recall From the Brief Visuospatial Memory Test-Revised Version (BVMT-R)	43.64 T-score Standard Deviation 8.66	46.16 T-score Standard Deviation 12.8	46.62 T-score Standard Deviation 14.4

PRIMARY outcome

Timeframe: 6 months followup

Visual Memory: Delayed Recall: A test that involves reproducing six geometric figures from memory after a 25 minute delay. T-scores range from 0-100, with higher T-scores corresponding to better performance. A T-score of 50 indicates the population mean (average) with a standard deviation of 10.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=2 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Visual Memory: Delayed Recall From the Brief Visuospatial Memory Test-Revised Version (BVMT-R)	48.16 T-score Standard Deviation 9.22	46.89 T-score Standard Deviation 9.56	48.67 T-score Standard Deviation 14.37

SECONDARY outcome

Timeframe: Baseline

Functional Capacity: This measure assesses how well everyday tasks are performed in two areas of functioning: communication (e.g. making an emergency call, calling a doctor to reschedule an appointment) and finances (e.g. counting change, reading a utility bill). Scaled scores range from 0-100 with higher scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=15 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=10 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
UCSF Performance-Based Skills Assessment (UPSA): Functional Capacity	73.33 Total score Standard Deviation 16.48	69.14 Total score Standard Deviation 9.71	73.58 Total score Standard Deviation 12.4

SECONDARY outcome

Timeframe: 6 weeks

Functional Capacity: This measure assesses how well everyday tasks are performed in two areas of functioning: communication (e.g. making an emergency call, calling a doctor to reschedule an appointment) and finances (e.g. counting change, reading a utility bill). Scaled scores range from 0-100 with higher scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=7 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
UCSF Performance-Based Skills Assessment (UPSA): Functional Capacity	61.05 Total score Standard Deviation 13.63	70.92 Total score Standard Deviation 14.66	76.31 Total score Standard Deviation 9.24

SECONDARY outcome

Timeframe: 6 months followup

Functional Capacity: This measure assesses how well everyday tasks are performed in two areas of functioning: communication (e.g. making an emergency call, calling a doctor to reschedule an appointment) and finances (e.g. counting change, reading a utility bill). Scaled scores range from 0-100 with higher scores indicating better performance.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=9 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=11 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
UCSF Performance-Based Skills Assessment (UPSA): Functional Capacity	69.42 Total score Standard Deviation 6.61	30.1 Total score Standard Deviation 41.4	67.86 Total score Standard Deviation 25.74

SECONDARY outcome

Timeframe: Baseline

Social Functioning: This measure assesses social skills and functioning in 7 domains: Withdrawal, Interaction, Pro-Social, Recreation, Independence- Performance, Independence-Competence, and Occupational. A mean domain score was calculated as the average across all domains. Scaled scores range from 55-145 with higher scores indicating better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Functioning Scale	106.73 subscale score Standard Deviation 9.2	107.15 subscale score Standard Deviation 7.71	106.45 subscale score Standard Deviation 8.09

SECONDARY outcome

Timeframe: 6 weeks

Social Functioning: This measure assesses social skills and functioning in 7 domains: Withdrawal, Interaction, Pro-Social, Recreation, Independence- Performance, Independence-Competence, and Occupational. A mean domain score was calculated as the average across all domains. Scaled scores range from 55-145 with higher scores indicating better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Functioning Scale	107 subscale score Standard Deviation 8.49	117.05 subscale score Standard Deviation 5.89	113.33 subscale score Standard Deviation 5.09

SECONDARY outcome

Timeframe: 6 months followup

Social Functioning: This measure assesses social skills and functioning in 7 domains: Withdrawal, Interaction, Pro-Social, Recreation, Independence- Performance, Independence-Competence, and Occupational. A mean domain score was calculated as the average across all domains. Scaled scores range from 55-145 with higher scores indicating better functioning.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=11 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=12 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Social Functioning Scale	107.58 subscale score Standard Deviation 10.47	121.09 subscale score Standard Deviation 5.05	112.43 subscale score Standard Deviation 8.06

SECONDARY outcome

Timeframe: Baseline

This measure assesses internalized stigma which occurs when a person adopts stigmatizing assumptions and stereotypes about mental illness. Participants rate 10 statements on a scale of 1 (strongly disagree) to 4 (strongly agree). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater internalized stigma.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=17 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=16 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Internalized Stigma of Mental Illness (ISMI)	2.11 Mean item score Standard Deviation 0.44	2.04 Mean item score Standard Deviation 0.47	1.76 Mean item score Standard Deviation 0.44

SECONDARY outcome

Timeframe: 6 weeks

This measure assesses internalized stigma which occurs when a person adopts stigmatizing assumptions and stereotypes about mental illness. Participants rate 10 statements on a scale of 1 (strongly disagree) to 4 (strongly agree). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater internalized stigma.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=14 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=8 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=10 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Internalized Stigma of Mental Illness (ISMI)	1.89 Mean item score Standard Deviation 0.33	1.69 Mean item score Standard Deviation 0.45	1.79 Mean item score Standard Deviation 0.38

SECONDARY outcome

Timeframe: 6 months followup

This measure assesses internalized stigma which occurs when a person adopts stigmatizing assumptions and stereotypes about mental illness. Participants rate 10 statements on a scale of 1 (strongly disagree) to 4 (strongly agree). A mean item score is computed as the average rating across all items, with higher mean item scores corresponding to greater internalized stigma.

Outcome measures

Outcome measures
Measure	General Cognitive Exercises (GCE) n=10 Participants Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=5 Participants Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Targeted Cognitive Training (TCT) n=13 Participants Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
Internalized Stigma of Mental Illness (ISMI)	2.14 Mean item score Standard Deviation 0.32	1.46 Mean item score Standard Deviation 0.3	1.74 Mean item score Standard Deviation 0.42

Adverse Events

Targeted Cognitive Training (TCT)

Serious events: 2 serious events

Other events: 0 other events

Deaths: 0 deaths

General Cognitive Exercises (GCE)

Serious events: 3 serious events

Other events: 0 other events

Deaths: 0 deaths

Treatment as Usual (TAU)

Serious events: 1 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure	Targeted Cognitive Training (TCT) n=16 participants at risk Neuroadaptive Cognitive Training Targeted Cognitive Training: 1. Auditory Training Module (20 hours): exercises designed to improve speed and accuracy of auditory processing while engaging working memory and cognitive control. Exercises adjust difficulty level to maintain an \~80% correct performance. Exercises contain stimuli spanning the acoustic organization of speech. In the initial stages, stimuli exaggerate the rapid temporal transitions by increasing amplitude and stretching in time. The exaggeration is gradually removed so that by the end, all stimuli have characteristics representative of real-world speech. 2\. Social Cognition Module (10 hours): exercises designed to improve core deficits of social cognition in psychosis. Exercises apply principles of implicit learning to restore capacity to process and utilize socially-relevant information, and includes training to improve perception of affect (visual/vocal) and social cues (faces, gazes, social situations), theory of mind, self-referential style, emotion labeling and working memory. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	General Cognitive Exercises (GCE) n=17 participants at risk Neuroadaptive cognitive training General Cognitive Exercises: The GCE will focus on executive dysfunction, as this domain is a significant, functionally important area of deficit in schizophrenia and has been the target of many previous studies. We will train this domain using a suite of engaging, adaptive web-based exercises that target executive function, intelligence, and spatial navigation developed by Posit Science. The exercises will be provide engaging, adaptive training as described in the Targeted Cognitive Training. Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.	Treatment as Usual (TAU) n=12 participants at risk Treatment as Usual Coordinated Specialty Care for First Episode Psychosis: Individuals in this study are receiving care from a coordinated specialty care clinic (CSC) for first episode psychosis. These clinics are following the NAVIGATE treatment model for early psychosis.
General disorders Hospitialization unrelated to study procedures.	12.5% 2/16 • Number of events 4 • Participants were randomized to 30 hours of TCT or GCE training or 12 weeks (whichever came first), or 12 weeks of TAU and completed baseline, post-intervention and 6 month follow-up assessments.	17.6% 3/17 • Number of events 3 • Participants were randomized to 30 hours of TCT or GCE training or 12 weeks (whichever came first), or 12 weeks of TAU and completed baseline, post-intervention and 6 month follow-up assessments.	8.3% 1/12 • Number of events 1 • Participants were randomized to 30 hours of TCT or GCE training or 12 weeks (whichever came first), or 12 weeks of TAU and completed baseline, post-intervention and 6 month follow-up assessments.

Other adverse events

Adverse event data not reported

Additional Information

Melissa Fisher

University of Minnesota

Phone: (612) 273-9812

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place