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Goodwin A, Jones EJH, Salomone S, et al. INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial. Transl Psychiatry. 2021;11(1):644doi: 10.1038/s41398-021-01698-9.
Goodwin, A., Jones, E. J. H., Salomone, S., Mason, L., Holman, R., Begum-Ali, J., Hunt, A., Ruddock, M., Vamvakas, G., Robinson, E., Holden, C. J., Taylor, C., Smith, T. J., Sonuga-Barke, E., Bolton, P., Charman, T., Pickles, A., Wass, S., Johnson, M. H. (2021). INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial. Translational psychiatry, 11(1), 644. https://doi.org/10.1038/s41398-021-01698-9
Goodwin, Amy, et al. "INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial." Translational psychiatry vol. 11,1 (2021): 644. doi: https://doi.org/10.1038/s41398-021-01698-9
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, Johnson MH. INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial. Transl Psychiatry. 2021 Dec 20;11(1):644. doi: 10.1038/s41398-021-01698-9. PMID: 34930893.
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Transl Psychiatry. 2021 Dec 20;11(1):644. doi: 10.1038/s41398-021-01698-9.

INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial.

Translational psychiatry

Amy Goodwin, Emily J H Jones, Simona Salomone, Luke Mason, Rebecca Holman, Jannath Begum-Ali, Anna Hunt, Martin Ruddock, George Vamvakas, Emily Robinson, Catherine J Holden, Chloë Taylor, Tim J Smith, Edmund Sonuga-Barke, Patrick Bolton, Tony Charman, Andrew Pickles, Sam Wass, Mark H Johnson,

Affiliations

  1. Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. [email protected].
  2. Centre for Brain and Cognitive Development, Department of Psychology, Birkbeck College, University of London, London, UK. [email protected].
  3. Centre for Brain and Cognitive Development, Department of Psychology, Birkbeck College, University of London, London, UK.
  4. Centre for Oral Clinical Research (COCR) & Centre for Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, London, UK.
  5. Department of Psychology, University of Southampton, Southampton, UK.
  6. Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
  7. Department of Psychology, University of East London, London, UK.
  8. Centre for Brain and Cognitive Development, Department of Psychology, Birkbeck College, University of London, London, UK. [email protected].
  9. Department of Psychology, University of Cambridge, Cambridge, UK. [email protected].

PMID: 34930893 DOI: 10.1038/s41398-021-01698-9

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.

© 2021. The Author(s).

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