Integrated Brain, Body and Social Intervention for ADHD

描述（由申请人提供）：该项目将评估和完善一种创新的多组分，神经科学为基础的，非药物干预注意缺陷多动障碍（ADHD）。ADHD影响超过5%的儿童，扰乱心理社会发展，并具有广泛的负面后果。药物治疗通常益处有限，容易被滥用，并伴有不必要的副作用。拟议的治疗方案是创新的：使用基于计算机的“治疗传递系统”，以应用新的知识，神经可塑性在临床护理;改造现有的方法，以体育教育的基础上认知神经科学;和使用基于证据的干预，从社会心理学，以提高交付和有效性的神经科学为基础的干预措施。 大脑，身体和社会干预的协同整合提供了一个适当的范例，以解决神经发育障碍的复杂性。创新的计算机程序具有多个新的专利功能，在以前的任何计算机认知治疗练习中都没有。创新的体育锻炼激活了与计算机练习相同的神经认知系统，但在全身和人际活动的背景下，这对ADHD特别重要。社会层面的干预有助于参与计算机和体育活动，它本身也激活了目标的自我调节系统。 我们的干预措施所依据的神经可塑性潜力已在动物和人类研究中得到了显着证明。它已成功地用于治疗成人神经病理学，但应用于儿童疾病一直显着缺席，尽管更大的可塑性在儿童时期。与基础科学的其他临床相关进展一样，如果要有效地应用新发现，治疗方法也必须取得进展。基于使用原型程序与儿童进行的初步研究和讨论，我们已经创建了创新的游戏式计算机程序，这些程序以临床前研究所表明的必要强度和一致性参与并激活目标神经认知系统。此外，新的研究还表明，由于遗传、环境、生理、心理、社会、初级和补偿过程的相互作用，神经发育障碍及其治疗是复杂的。例如，ADHD的核心特征改变了与环境的相互作用，从而加剧了症状本身，产生了额外的问题并阻碍了有效的治疗。因此，需要协同整合大脑，行为和社会观点和方法的新范式来治疗这些疾病。我们的计划是专为6至8岁的儿童，以便在临床相关的神经功能系统正在积极发展和临床症状首次出现时进行精确干预。 公共卫生相关性：该项目将评估和完善一种创新的多成分，神经科学为基础的，非药物干预注意缺陷多动障碍。该干预措施在以下方面具有创新性：使用新获得专利的基于计算机的“治疗提供系统”，将神经可塑性的新知识应用于临床护理;根据认知神经科学改造现有的体育教育方法;以及使用课堂游戏来提高有注意力问题的儿童的参与。

DESCRIPTION (provided by applicant): This project will evaluate and refine an innovative multi-component, neuroscience based, non- pharmacologic intervention for Attention Deficit Hyperactivity Disorder (ADHD). ADHD affects >5% of children, disrupts psychosocial development, and has broad negative outcomes. Pharmacotherapy is often of limited benefit, subject to misuse and associated with unwanted side effects. The proposed treatment program is innovative in: use of a computer based "treatment delivery system" to apply new knowledge of neuroplasticity in clinical care; transformation of existing approaches to physical education based on cognitive neuroscience; and use of an evidence based intervention from social psychology to enhance delivery and effectiveness of neuroscience based interventions. Synergistic integration of brain, body and social interventions provides a paradigm appropriate to address the complexities of neurodevelopmental disorders. The innovative computer programs have multiple newly patented capabilities not present in any previous computerized cognitive treatment exercises. Innovative physical exercises activate the same neurocognitive systems targeted by the computer exercises but in the context of whole body and inter-personal activity, particularly important for ADHD. The social level intervention facilitates participation in the computer and physical activities and it itself also activates target self-regulatory systems. Neuroplastic potential upon which our intervention is based has been dramatically demonstrated in animal and human studies. It has been successfully harnessed for treatment of adult neuropathology but application to childhood disorders has been remarkably absent despite greater plasticity during childhood. As with other clinically relevant advances in basic science, advances are also necessary in methods for treatment delivery if the new discoveries are to be applied effectively. Based on preliminary studies and discussions with the children using prototype programs, we have created innovative game-like computer programs that engage and activate targeted neurocognitive systems with the intensity and consistency that preclinical studies indicate is necessary. Moreover, new research also demonstrates the complexity of neurodevelopment disorders and their treatment due to the interplay of genetic, environmental, physiological, psychological, social, primary and compensatory processes. For example, core features of ADHD alter interactions with the environment in ways that aggravate the symptoms themselves, create additional problems and block effective delivery of treatment. New paradigms that synergistically integrate brain, behavior and social perspectives and methods are therefore needed to treat these disorders. Our program is designed for six to eight year old children in order to intervene precisely when the clinically relevant neurofunctional systems are actively developing and when clinical symptoms first appear. PUBLIC HEALTH RELEVANCE: This project will evaluate and refine an innovative multi-component, neuroscience based, non-pharmacologic intervention for Attention Deficit Hyperactivity Disorder. The intervention is innovative in: use of a newly patented computer based "treatment delivery system" to apply new knowledge of neuroplasticity in clinical care; transformation of existing approaches to physical education based on cognitive neuroscience; and use of a classroom game to enhance participation by children with attention problems.