Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the Attention Control Training (ACT) randomised trial

Abstract

Background Very premature birth (gestational age between 28 and 31 + 6 weeks) is associated with increased risk of cognitive delay and attention deficit disorder, which have been linked to anomalies in the development of executive functions (EFs) and their precursors. In particular, very preterm (VP) infants display anomalies in controlling attention and gathering task-relevant information. Early interventions that support attention control may be pivotal in providing a secure base for VP children’s later attainments. The Attention Control Training (ACT) is a cognitive training intervention that targets infants’ abilities to select visual information according to varying task demands but had not been tested in VP infants. We conducted a feasibility study to test the processes we intend to use in a trial delivering the ACT to VP infants. Methods and design We tested recruitment and retention of VP infants and their families in a randomised trial, as well as acceptability and completion of baseline and outcome measures. To evaluate these aims, we used descriptive quantitative statistics and qualitative methods to analyse feedback from infants’ caregivers. We also investigated the quality of eye-tracking data collected and indicators of infants’ engagement in the training, using descriptive statistics. Results Twelve VP infants were recruited, and 10 (83%) completed the study. Participants’ parents had high education attainment. The rate of completion of baseline and outcome measures was optimal. VP infants demonstrated engagement in the training, completing on average 84 min of training over three visits, and displaying improved performance during this training. Eye-tracking data quality was moderate, but this did not interfere with infants’ engagement in the training. Discussion The results suggest the ACT can be delivered to VP infants. However, challenges remain in recruitment of numerous and diverse samples. We discuss strategies to overcome these challenges informed by results of this study. Trial registration Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).

Gaze-Contingent Eye-Tracking Training in Brain Disorders: A Systematic Review

“…Sample sizes were relatively small in the majority of the studies: only five studies included more than fifty subjects [ 25 , 36 , 39 , 46 , 48 ]; ten had 25–50 subjects [ 28 , 29 , 32 , 34 , 37 , 41 , 43 , 44 , 45 , 47 ]; and seven had 10–25 subjects [ 30 , 31 , 33 , 35 , 38 , 40 , 42 ].…”

Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns

“…Additionally, the calculator showed specificity for ADHD compared to other common child psychopathology (anxiety disorders and oppositional defiant disorder). Although an emerging literature is suggesting that early interventions might have a role for individuals at risk for ADHD (Perra et al., 2021), the choice of a clinically reasonable range of appropriate risk thresholds will depend on (a) further validity studies, (b) characteristics of future early interventions, and (c) individual clinician and parental preferences.…”

“…Interventions are being developed specifically for the prevention of ADHD in VP/VLBW infants. A recent study (Perra et al., 2021) shows the feasibility of delivering a cognitive training program to infants about 1 year of age born VP. They were able to engage adequately in a cognitive training intervention to train their control of attention, improving performance across training visits, and achieving good treatment adherence and acceptability of outcome measures.…”

“…However, there are challenges in recruiting this hard‐to‐reach population (Perra et al., 2021). To date, clinicians have no markers to discriminate which among those children born VP/VLBW will develop ADHD in the future, based only on the clinical presentation at birth.…”

Correction to: Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the attention control training (ACT) randomised trial

“…Following publication of the original article [ 1 ], the authors reported an omission in the list of authors, having failed to recognise Aaron Patterson for his contribution to data collection.…”