Integrated Brain, Body and Social Intervention for ADHD

描述（由申请人提供）：本项目将评估和完善一种创新的多成分、基于神经科学的非药物干预方法，用于治疗注意缺陷多动障碍（ADHD）。多动症影响了5%的儿童，扰乱了心理社会发展，并产生了广泛的负面后果。药物治疗的益处往往有限，容易被误用，并伴有不良副作用。提出的治疗方案在以下方面具有创新性：使用基于计算机的“治疗传递系统”，将神经可塑性的新知识应用于临床护理；基于认知神经科学的现有体育教学方法改造并使用基于证据的社会心理学干预来增强基于神经科学的干预的传递和有效性。脑、身体和社会干预的协同整合为解决神经发育障碍的复杂性提供了一个合适的范例。创新的计算机程序有多个新专利的能力，不存在于任何以前的计算机认知治疗练习。创新的体育锻炼激活了与电脑锻炼相同的神经认知系统，但在整个身体和人际活动的背景下，这对多动症尤其重要。社会层面的干预促进了计算机和身体活动的参与，它本身也激活了目标自我调节系统。我们的干预所基于的神经可塑性已经在动物和人类研究中得到了显著的证明。它已经成功地用于治疗成人神经病理学，但应用于儿童疾病一直明显缺席，尽管儿童时期可塑性更大。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，也需要在治疗方法上取得进展。基于初步研究和使用原型程序与儿童的讨论，我们创造了创新的游戏式计算机程序，以临床前研究表明必要的强度和一致性参与和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、初级和代偿过程的相互作用，神经发育障碍及其治疗的复杂性。例如，多动症的核心特征改变了与环境的相互作用，从而加重了症状本身，产生了额外的问题，阻碍了治疗的有效实施。因此，需要将大脑、行为和社会观点和方法协同结合起来的新范式来治疗这些疾病。我们的项目是为6到8岁的儿童设计的，以便在临床相关的神经功能系统积极发育和临床症状首次出现时进行精确的干预。

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.