INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial.
Holden, Catherine J
Smith, Tim J
Johnson, Mark H
the INTERSTAARS team
Springer Science and Business Media LLC
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Goodwin, A., Jones, E. J., Salomone, S., Mason, L., Holman, R., Begum-Ali, J., Hunt, A., et al. (2021). INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial.. Transl Psychiatry, 11 (1) https://doi.org/10.1038/s41398-021-01698-9
Funder: MQ: Transforming Mental Health (MQ); Grant(s): MQ14PP83
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.
Medical Research Council (MR/K021389/1)
External DOI: https://doi.org/10.1038/s41398-021-01698-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333243
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/