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Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

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

Published in: Trials | Issue 1/2016

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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.
Appendix
Available only for authorised users
Footnotes
1
Standardised questionnaires will be administered over the phone with the parent by a trained researcher. For siblings < 6 years of age, a shortened version of the Conners Early Childhood [40] will be administered. For siblings >= 6 years of age, a shortened version of the Conners 3 [54] will be administered. Cut offs for inclusion will be the presence of 4 (Conners Early Childhood) or 5 (Conners 3) DSM-5 ADHD symptoms on either the hyperactivity/impulsivity or inattention scale, and a positive score on the impairment scale. For parents, a shortened version of the Conners Adults ADHD Rating Scale (CAARS) [55] will be administered. Cut offs for inclusion using the CAARS will be the presence of 5 DSM-5 ADHD symptoms on either the hyperactivity/impulsivity or inattention scale.
 
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Metadata
Title
Attention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial
Publication date
01-12-2016
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1727-0

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