The Feasibility of a Brief Attention Training Technique in Improving Behaviour and Attention in Children With ADHD

Overview

This study aims to investigate the application of the Attention Training Technique in children with ADHD aged 7-11 years old. The research aims to investigate both the feasibility of this technique in this population as well as whether it can improve symptoms, behaviour and executive functioning.

Full Title of Study: “The Feasibility of a Brief Attention Training Technique for Improving Behaviour and Attention in Children With ADHD”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 2016

Detailed Description

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioural disorder characterised by core symptoms of hyperactivity, impulsivity and inattention. Its prevalence ranges between 3-9% of school-aged children, making it one of the most common presentations in child and adolescent mental health services. In the last 10 years, research into the effectiveness of attention training as an intervention for children with ADHD has been increasing. This has tended to follow assumptions that children with the disorder either lack skills in focusing and maintaining their attention and/or have neurological deficits in areas responsible for attention functions. Results have been encouraging, with study participants demonstrating improvements in symptoms and behaviour following a course of attention training. However, the method and length of training has varied across studies. This study aims to investigate a treatment called the Attention Training Technique (ATT) that approaches attention difficulties in this disorder from a different perspective. Instead of viewing inattention as a result of structural or skills deficits, it posits that children with ADHD have these skills, but are perhaps unaware of the flexibility and control they have over them. This treatment aims to increase this awareness and subsequently improve ratings of attention, behaviour and other areas of executive functioning.

Interventions

  • Behavioral: Attention Training Technique

Arms, Groups and Cohorts

  • Experimental: Attention Training Technique (ATT)
    • Participants will receive 3-5 sessions of the ATT over a period of 3-5 weeks. A set of standardised instructions will be read to each participant and then they will engage in the procedure for a period of 12 minutes. Participants will listen to a set of auditory stimuli and follow the directions of the recording. This will ask them to focus their attention on selected sounds or spatial locations, switch attention between different sounds and locations, before allocating their attention to all sounds simultaneously. Participants will be given a recording of the ATT on a C.D and asked to practice this at least once before the second session.

Clinical Trial Outcome Measures

Primary Measures

  • Inattention on the Swanson, Nolan and Pelham questionnaire (Snap-IV)
    • Time Frame: Change from baseline in attention post treatment and at follow up 6 weeks later
    • Parent’s rating of their child’s inattentiveness

Secondary Measures

  • Hyperactivity on the Swanson, Nolan and Pelham questionnaire (Snap-IV)
    • Time Frame: Change from baseline in hyperactivity post treatment and at follow up 6 weeks later
    • Parent’s rating of their child’s hyperactivity
  • Impulsivity on the Swanson, Nolan and Pelham questionnaire (Snap-IV)
    • Time Frame: Change from baseline in impulsivity post treatment and at follow up 6 weeks later
    • Parent’s rating of their child’s impulsivity
  • Attentional control on the Attentional Control Scale for Children (ASC-C)
    • Time Frame: Change from baseline in attentional control post treatment and at follow up 6 weeks later
    • Children’s self reported ability to focus and shift their attention
  • Behaviour on the Strengths and Difficulties Questionnaire (SDQ)
    • Time Frame: Change from baseline in behaviour post treatment and at follow up 6 weeks later
    • Parent’s ratings of their child’s behaviours
  • Executive functioning on The Behavioural Rating Inventory of Executive Functioning (BRIEF)
    • Time Frame: Change from baseline in executive functioning post treatment and at follow up 6 weeks later
    • Parent’s ratings of their child’s executive functioning behaviours in the home environment
  • Working memory on the Weschler Intelligence Scale for Children (WISC-IV) – Digit Span
    • Time Frame: Change from baseline in working memory post treatment and at follow up 6 weeks later
    • Children’s Working memory as assessed by the Digit Span subtest
  • Working memory on the Weschler Intelligence Scale for Children (WISC-IV) – Letter Number Sequencing
    • Time Frame: Change from baseline in working memory post treatment and at follow up 6 weeks later
    • Children’s Working memory as assessed by the Letter Number Sequencing subtest
  • Treatment Acceptability Questionnaire
    • Time Frame: Rated once at the final session of treatment, 4 weeks after the 2nd baseline is taken
    • Parents rating of the acceptability of the treatment

Participating in This Clinical Trial

Inclusion Criteria

  • Children with a formal diagnosis of ADHD as given by a psychiatrist or community paediatrician – Children between the ages of 7 and 11. This age group was selected as previous research on attention training in this population has used this age group – Children who are currently on a waiting list at a Child and Adolescent Mental Health Service (CAMHS) or a child psychology service, or being seen by a CAMHS or psychology service for medication review only – Children who speak fluent English which will ensure they are able to comprehend the tasks instructions adequately. Exclusion Criteria:

  • Children who are not stabilised on stimulant medication and/or willing to maintain their medication type/dose – Children with a major neurological illness or acquired central nervous system injury – Children who at the point of referral have a co-existing diagnosis of an Autistic Spectrum Disorder – Children who are currently in receipt of another non-pharmacological intervention for ADHD or who are currently taking part in another research trial

Gender Eligibility: All

Minimum Age: 7 Years

Maximum Age: 11 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Manchester
  • Provider of Information About this Clinical Study
    • Principal Investigator: Adrian Wells, Professor of Clinical and Experimental Psychopathology – University of Manchester
  • Overall Official(s)
    • Adrian Wells, Principal Investigator, University of Manchester

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