Training attention in children with acquired brain injury: a study protocol of a randomised controlled trial of the TALI attention training programme

Abstract

IntroductionChildhood inattention has been linked with poor academic outcomes, and increased lifetime social, occupational and psychiatric morbidity. Children with an acquired brain injury (ABI) are particularly susceptible to attention deficits and may benefit from interventions aimed at enhancing attention. The primary objective of this study is to evaluate the short-term efficacy of the TALI Train programme, compared with a placebo, on the outcome of attention in children with ABI.Methods and analysisThe study is a parallel, double-blind, randomised controlled trial. Participants will consist of 80 children with a diagnosis of ABI aged 4–9 years 11 months. Participants will be randomly allocated to either (1) TALI Train (intervention group), an adaptive game-based attention training programme, or (2) a non-adaptive placebo programme (control group). Both programmes are delivered on a touchscreen tablet, and children complete five 20 min sessions per week for a 5-week period at home. Assessment of selective, sustained and executive attention (primary outcomes), and behavioural attention, working memory, social skills and mathematics ability (secondary outcomes) will occur at baseline, post-training, and at 3-month and 6-month follow-up to assess immediate and long-term efficacy of TALI Train compared with placebo. Assessments will be completed at the Royal Children’s Hospital in Melbourne, Australia. All assessments and analyses will be undertaken by researchers blinded to group membership. Latent growth curve modelling will be employed to examine primary and secondary outcomes.Ethics and disseminationEthics approval has been obtained from the Royal Children’s Hospital Human Research Ethics Committee (HREC) (38132) and the Monash University HREC (17446). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities.Trial registration numberACTRN12619000511134.

Early Visual Deprivation Impairs Functional Development of the Visual Ventral Stream

“…We propose that a more beneficial method composed of an attentional alerting system and vision tasks probably contributes to the success of visual recognition. Several training programs have been proposed to improve executive attention in several groups with different mental disabilities and have been proven effective in top-down attention improvement, 76 – 78 whereas their availability for children with innate visual impairment needs further clinical invalidation.…”

Evaluating the feasibility and efficacy of the Amsterdam memory and attention training for children (Amat-c) following acquired brain injury (ABI): protocol for a pilot study with online clinician support

“…Models of attention (Gilboa et al, 2015;Limond, Adlam & Cormack, 2014;Mirsky, Anthony, Duncan, Ahearn & Kellam, 1991) distinguish between various aspects of attentional skills, including sustained attention (i.e., vigilance), selective attention (i.e., focusing on relevant stimuli and ignoring irrelevant stimuli), shifting attention (i.e., changing attentional focus in an adaptive and flexible manner), divided attention (i.e., dividing attention between two or more sources of information), attentional control (i.e., ability to inhibit responses), and speed of processing (i.e., rate of completing responses). There is substantial evidence that children with ABI are vulnerable to deficits in each of these domains (McKay et al, 2019;van't Hooft, Andersson, Sejersen, Bartfai & von Wendt, 2003). For example, in a sample of 71 children with TBI, Catroppa and Anderson (2005) showed deficits on measures of sustained, selective, and shifting attention, as well as slowed processing speed, particularly for children with more severe injuries.…”