Teaching attentional awareness and control in ADHD

教授注意力缺陷多动症的注意力意识和控制

• 批准号: 10619193
• 负责人: GREGORY V SIMPSON
• 金额: $ 4.5万
• 依托单位: THINK NOW, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-02 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10619193
• 关键词: Academic achievement; Active Learning; Adherence; Adult; Area; Attention; Attention deficit hyperactivity disorder; Automobile Driving; Awareness; Brain; Complex; Comprehension; Computer software; Control Groups; Disease; Double-Blind Method; Educational process of instructing; Exercise; Feedback; Impairment; Intention; Interview; Learning; Legal patent; Life; Literature; Measures; Methods; Modeling; Motivation; Oral; Outcome Measure; Participant; Patients; Performance; Pharmacology; Phase; Psychological Transfer; Reading; Research; Safety; Self Perception; Severities; Skin; Software Tools; Standardization; Step training; Symptoms; Testing; Time; Training; Work; active control; attentional control; base; commercialization; design; economic impact; efficacy testing; evidence base; expectation; improved; inattention; innovation; mobile application; primary outcome; programs; prototype; reading comprehension; remediation; skills; social; sustained attention; tool; web-based tool

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].

摘要。ADHD是一种非常普遍的疾病，它会在职业、社会和个人生活中造成严重的影响。 患者的困难-存在对额外的非药物治疗的真实的需求。的目标 我们的产品是不一致的持续注意力的控制，一个重要的补救目标多动症， 现实生活中的重大影响。持续注意力与症状严重程度相关，与现实生活功能相关 例如阅读、听力、驾驶和工作安全。持续注意力措施和注意力不集中症状 ADHD也与学业成绩有关。持续注意力控制（SAC） 这种方法与“大脑训练”方法截然不同，它采用了一种创新的（专利）方法， 体验式学习的模型和实证研究。它包括六个基本的教学因素，确定在 促进有意义的学习和迁移的文献，使用户有别于现有产品（表 1、商业化计划）。当对注意力控制的概念性理解， 发展自我意识和元认知技能。在之前的第一阶段项目中，我们建立了一个原型， SAC教学移动软件，并在一项完整的RCT、双盲、主动对照研究中对其进行测试（n=63）。我们发现 SAC组在两个主要结局方面的改善均显著大于活性对照组 测量：持续注意力测量（Conners CPT RT变异性）和限时阅读 理解（纳尔逊-丹尼阅读测试），证明远转移到一个重要的标准化测试 ADHD成年人的实际活动受损。根据这项研究的离职面谈，我们进行了额外的 设计工作和广泛的客户研究表明，患有ADHD的成年人需要额外的步骤， 发展元认知技能的培训，将他们的注意力意识应用到日常生活中。为了回答这个问题 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距离传输结果。离职面谈 还确定了与用户体验和激励/坚持相关的SAC模块的改进领域 第二阶段。第一阶段：目标1：建立和测试学习迁移（LTT）模块，一个复杂的专注于学习的模块。 听力任务模拟日常生活中的听力挑战，与性能反馈。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易用性;添加培训练习， 增加皮肤的多样性;提高难度水平;增加新的规定性工具的反射和应用， 学习日常生活活动。第二阶段：目标3：测试完全一体化原型（扩展）的功效 SAC+LTT）与RCT、双盲、活性对照研究，140例受试者，使用意向治疗 设计，具有远迁移的结果测量[纳尔逊丹尼阅读理解; STISIM驾驶 模拟器测试; Woodcock-Johnson口腔理解; BAARS-IV症状]。