Teaching attentional awareness and control in ADHD

抽象的。ADHD是一种非常普遍的疾病，它会造成重大的职业、社会和个人方面的障碍 患者的困难--确实需要额外的非药物治疗。的目标是 我们的产品是对持续注意力的不一致控制，这是ADHD的重要补救目标 对现实生活的重大影响。持续注意力与症状严重程度相关，与现实生活功能相关 如阅读、听力、驾驶和安全生产。持续注意力测量和注意力不集中症状 ADHD也与学业成绩有关。我们的持续注意力控制(SAC)教学 这种方法与“大脑训练”方法有很大的不同，它使用了一种创新的(获得专利的)方法， 体验式学习的模型和循证研究。它包括6个基本的教学要素，在 促进有意义的学习和迁移的文献，使我们有别于现有产品(表 1、商业化计划)。当对注意控制有一个概念性的理解时， 发展自我意识和元认知技能。在之前的第一阶段项目中，我们构建了我们的 SAC教学移动软件，并对其进行完全随机对照、双盲、主动对照、研究(n=63)。我们发现 SAC组在两个主要结果上的改善均显著高于主动控制组 测量：持续注意力测量(Conners CPT RT变异性)和限时阅读 理解力(Nelson-Denny阅读测试)，演示了向标准化考试的一项重要迁移 患有ADHD的成年人在现实生活中的活动受到损害。根据该研究的离职访谈，我们还进行了 设计工作和广泛的客户研究表明，患有ADHD的成年人需要额外的步骤 培养元认知技能，以便将注意力应用到日常生活中的培训。作为对此的回答 需要时，我们设计了学习到迁移模块(此快速通道的第一阶段)，期望在 与SAC(这条快速通道的第二阶段)相结合，它将扩大我们之前的FAR转移结果。离职面谈 还确定了与用户体验和激励/遵从性相关的SAC模块需要改进的领域 第二阶段。我们将：阶段I：目标1：构建和测试学习到迁移(LTT)模块，这是一个复杂的注意力集中的模块 听力任务模拟日常生活中的听力挑战，并提供成绩反馈。第二阶段：目标2：整合 LTT纳入SAC教学计划。构建软件工具以提高UX的易用性；添加培训练习和 增加皮肤的多样性；提高难度等级；增加反射和应用的新规范工具 学会日常生活活动。第二阶段：目标-3：测试完全集成原型(扩展)的有效性 SAC LTT)，采用随机对照、双盲、主动对照研究，有140名参与者，采用意向治疗 设计，以及对远迁移的结果测量[Nelson Denny阅读理解；STISIM驾驶 模拟器测试；Woodcock-Johnson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].