Goodwin, A, Jones, EJH, Salomone, S, Mason, L, Holman, R, Begum-Ali, J, Hunt, A, Ruddock, M, Vamvakas, G, Robinson, E, Holden, CJ, Taylor, C, Smith, TJ, Sonuga-Barke, E, Bolton, P, Charman, T, Pickles, A, Wass, S and Johnson, MH (2021) INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial. Translational Psychiatry, 11 (1). ISSN 2158-3188

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Abstract

Attention-deficit/hyperactivity disorder (ADHD) is first diagnosed during middle childhood, when patterns of difficulty are often established. Pre-emptive approaches that strengthen developing cognitive systems could offer an alternative to post-diagnostic interventions. This proof-of-concept randomised controlled trial (RCT) tested whether computerised gaze-based attention training is feasible and improves attention in infants liable to develop ADHD. Forty-three 9- to 16-month-old infants with a first-degree relative with ADHD were recruited (11/2015–11/2018) at two UK sites and randomised with minimisation by site and sex to receive 9 weekly sessions of either (a) gaze-contingent attention training (intervention; n = 20); or (b) infant-friendly passive viewing of videos (control, n = 23). Sessions were delivered at home with blinded outcome assessments. The primary outcome was a composite of attention measures jointly analysed via a multivariate ANCOVA with a combined effect size (ES) from coefficients at baseline, midpoint and endpoint (Registration: ISRCTN37683928). Uptake and compliance was good but intention-to-treat analysis showed no significant differences between 20 intervention and 23 control infants on primary (ES −0.4, 95% CI −0.9 to 0.2; Complier-Average-Causal Effect ES −0.6, 95% CI −1.6 to 0.5) or secondary outcomes (behavioural attention). There were no adverse effects on sleep but a small increase in post-intervention session fussiness. Although feasible, there was no support for short-term effects of gaze-based attention training on attention skills in early ADHD. Longer-term outcomes remain to be assessed. The study highlights challenges and opportunities for pre-emptive intervention approaches to the management of ADHD.

Item Type:	Article
Uncontrolled Keywords:	Science & Technology; Life Sciences & Biomedicine; Psychiatry; DEFICIT/HYPERACTIVITY DISORDER; OUTCOMES; METAANALYSIS; PREVALENCE; DURATION; PATHWAYS; BEHAVIOR; CHILDREN; the INTERSTAARS team; Humans; Treatment Outcome; Attention; Attention Deficit Disorder with Hyperactivity; Child; Infant; Attention; Attention Deficit Disorder with Hyperactivity; Child; Humans; Infant; Treatment Outcome; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1701 Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Psychology (from Sep 2019)
Publisher:	Nature Publishing Group
SWORD Depositor:	A Symplectic
Date Deposited:	19 May 2022 10:09
Last Modified:	19 May 2022 10:15
DOI or ID number:	10.1038/s41398-021-01698-9
URI:	https://researchonline.ljmu.ac.uk/id/eprint/16873

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