Teaching attentional awareness and control in ADHD

抽象的。 ADHD 是一种非常普遍的疾病，会对职业、社会和个人造成重大影响 患者面临的困难 - 确实需要额外的非药物治疗。的目标 我们的产品对持续注意力的控制不一致，这是多动症的重要补救目标 对现实生活产生重大影响。持续注意力与症状严重程度相关，并与现实生活功能相关 例如阅读、听力、驾驶和工作安全。持续注意力测量和注意力不集中症状 ADHD 也与学业成绩相关。我们的持续注意力控制（SAC）教学 该方法与“大脑训练”方法有很大不同，并且使用基于 体验式学习的模型和循证研究。它包括 6 个基本教学因素，确定于 促进有意义的学习和迁移的文献，使我们与现有产品区分开来（表 1、商业化计划）。当对注意力控制的概念性理解时，可以发生更好的转移， 自我意识和元认知技能得到发展。在之前的第一阶段项目中，我们构建了我们的原型 SAC 教授移动软件，并在完整的随机对照试验、双盲、主动控制研究中对其进行了测试 (n=63)。我们发现 SAC 组在两个主要结局方面均比主动对照组有显着更大的改善 措施：持续注意力措施（Conners CPT RT Variability）和限时阅读 理解力（纳尔逊-丹尼阅读测试），展示了对重要知识的标准化测试的远迁移 患有多动症的成年人的现实生活活动受损。根据该研究的退出访谈，我们进行了额外的 设计工作和广泛的客户研究表明，患有多动症的成年人需要采取额外的步骤 培养元认知技能的培训，以便将他们的注意力意识应用到日常生活中。对此的回答 需要，我们设计了学习迁移模块（此快速通道的第一阶段），期望当 与 SAC（此快速通道的第二阶段）集成，它将放大我们之前的远传输结果。离职面谈 还确定了与用户体验和动机/坚持相关的 SAC 模块需要改进的领域 第二阶段。我们将： 第一阶段：目标 1：构建并测试学习迁移（LTT）模块，这是一个复杂的专注模块 听力任务模拟日常生活听力挑战，并提供表现反馈。第二阶段：目标 2：整合 LTT进入SAC教学计划。构建软件工具以提高用户体验的易用性；添加训练练习并 增加皮肤的多样性；提高难度等级；添加新的规范工具用于反思和应用 学习日常生活活动。第二阶段：目标 3：测试完全集成原型的功效（扩展 SAC LTT）与一项随机对照试验、双盲、主动对照研究，有 140 名参与者参与，使用意向治疗 设计，以及远转移的结果测量[Nelson Denny 阅读理解； STISIM驾驶 模拟器测试；伍德科克-约翰逊口语理解； BAARS-IV 症状]。

ABSTRACT. ADHD is a highly prevalent disorder that creates significant professional, social and personal difficulties for the patients - there is a real need for additional, non-pharmacological treatments. The target of our product is inconsistent control of sustained attention, an important remediation target for ADHD with major real-life impact. Sustained attention is related to symptom severity and correlated with real-life functions such as reading, listening, driving and work safety. Sustained attention measures and inattention symptoms in ADHD have also been correlated with academic achievement. Our Sustained Attention Control (SAC) teaching approach is quite different from ‘brain training’ methods and uses an innovative (patented) approach based on models and evidence-based studies of experiential learning. It includes 6 essential teaching factors, identified in the literature for promoting meaningful learning and transfer, that differentiate us from existing products (Table 1, Commercialization Plan). Better transfer can occur when a conceptual understanding of attentional control, self-awareness and metacognitive skills are developed. In a previous Phase-I project we built a prototype of our SAC teaching mobile-software and tested it in a full RCT, double-blind, active control, study (n=63). We found significantly greater improvements in the SAC group than the active Control group on both primary outcome measures: a sustained attention measure (Conners CPT RT Variability), and time-limited reading comprehension (Nelson-Denny Reading Test), demonstrating far transfer to a standardized test of an important real-life activity impaired in adults with ADHD. Based on exit interviews from that study we conducted additional design work and extensive customer research that revealed that adults with ADHD need an additional step of training that develops metacognitive skills for applying their attentional awareness to daily life. In answer to this need, we designed the Learning-To-Transfer module (Phase-I of this Fast Track) with the expectation that, when integrated with SAC (Phase-II of this Fast Track), it will amplify our prior far transfer results. The exit interviews also identified areas for improvement of the SAC modules related to UX and motivation/adherence to be built in Phase-II. We will: PHASE-I:Aim-1: Build and test the Learning-To-Transfer (LTT) module, a complex attentive listening task simulating daily life listening challenges, with performance feedback. PHASE-II: Aim-2: Integrate LTT into the SAC teaching program. Build software tools to improve UX ease of use; add a training exercise and increase skins for variety; improve difficulty leveling; add new prescriptive tool for reflection and applications of learning to daily-life activities. PHASE-II: Aim-3: Test the efficacy of fully integrated prototype (expanded SAC+LTT) with a RCT, double-blind, active control study with 140 participants, using an Intention-To-Treat design, with outcome measures for far transfer [Nelson Denny Reading Comprehension; STISIM Driving Simulator test; Woodcock-Johnson Oral Comprehension; BAARS-IV Symptoms].