Attention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial

Article


Goodwin, Amy, Salomone, Simona, Bolton, Patrick, Charman, Tony, Jones, Emily J. H., Pickles, Andrew, Robinson, Emily, Smith, Tim, Sonuga-Barke, Edmund J. S., Wass, S. and Johnson, Mark H. 2016. Attention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial. Trials. 17 (1), p. 608. https://doi.org/10.1186/s13063-016-1727-0
AuthorsGoodwin, Amy, Salomone, Simona, Bolton, Patrick, Charman, Tony, Jones, Emily J. H., Pickles, Andrew, Robinson, Emily, Smith, Tim, Sonuga-Barke, Edmund J. S., Wass, S. and Johnson, Mark H.
Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that can
negatively impact on an individual’s quality of life. It is pathophysiologically complex and heterogeneous with
different neuropsychological processes being impaired in different individuals. Executive function deficits, including
those affecting attention, working memory and inhibitory control, are common. Cognitive training has been promoted
as a treatment option, based on the notion that by strengthening the neurocognitive networks underlying these
executive processes, ADHD symptoms will also be reduced. However, if implemented in childhood or later, when the
full disorder has become well-established, cognitive training has only limited value. INTERSTAARS is a trial designed to
test a novel approach to intervention, in which cognitive training is implemented early in development, before the
emergence of the disorder. The aim of INTERSTAARS is to train early executive skills, thereby increasing resilience and
reducing later ADHD symptoms and associated impairment.
Methods/design: Fifty 10–14-month-old infants at familial risk of ADHD will participate in INTERSTAARS. Infants
will be randomised to an intervention or a control group. The intervention aims to train early attention skills
by using novel eye-tracking technology and gaze-contingent training paradigms. Infants view animated games
on a screen and different events take place contingent on where on the screen the infant is looking. Infants
allocated to the intervention will receive nine weekly home-based attention training sessions. Control group
infants will also receive nine weekly home visits, but instead of viewing the training games during these visits
they will view non-gaze-contingent age-appropriate videos. At baseline and post treatment, infant attention
control will be assessed using a range of eye-tracking, observational, parent-report and neurophysiological
measures. The primary outcome will be a composite of eye-tracking tasks used to assess infant attention skills.
Follow-up data will be collected on emerging ADHD symptoms when the infants are 2 and 3 years old.
Discussion: This is the first randomised controlled trial to assess the potential efficacy of cognitive training as
a prevention measure for infants at familial risk of ADHD. If successful, INTERSTAARS could offer a promising
new approach for developing early interventions for ADHD.
Trial registration: International Standard Randomised Controlled Trial registry: ISRCTN37683928. Registered on
22 June 2015.

KeywordsADHD; Attention; Infancy; Cognitive training; Early intervention; Familial risk
JournalTrials
Journal citation17 (1), p. 608
ISSN1745-6215
Year2016
PublisherBioMed Central
Publisher's version
License
CC BY
Digital Object Identifier (DOI)https://doi.org/10.1186/s13063-016-1727-0
Web address (URL)http://hdl.handle.net/10552/6415
Publication dates
Print28 Dec 2016
Publication process dates
Deposited04 Jan 2017
Accepted31 Oct 2016
FunderMQ: Transforming mental health UK
UK Medical Research Council
MQ: Transforming mental health UK
Medical Research Council
External resourceAttention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial
Copyright information© The Authors, 2016
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