ABSTRACT
University represents a time of both great uncertainty and change as well as a time of opportunity and learning. University students represent a population both at a higher risk of experiencing poor mental health and diagnosis and a population with relatively greater access and communication of both mental health literacy resources and mental health support services. Despite this, we consistently see low intention of help-seeking for mental health services or health services, with a clear preference shown for personal contacts such as friends or parents. To understand help-seeking intentions and their relationship with well-being, the current study explored two core hypotheses, when assessing a broad range of help-seeking options, the likelihood of seeking support from a range of sources will cluster together to create help-seeking groupings that can be further explored (1) and that across these help-seeking factors, there would be difference in intention score across students who fall within "at-risk," "low," or "normal to high" well-being groupings (2). Through a series of exploratory factor analysis (EFA) on a subsample (N = 178) and final confirmatory factor analysis (N = 1597) identified five help-seeking factors: Intimate Partner (single item), Personal Relations (friends, parents, and other relatives), External Health Service (external mental health provider and health provider), University Health Service (university mental health and health provider), and Digital and Distal Professional (digital apps, websites or forums, telehealth, religious leaders, and phone or online emergency services). To address hypothesis 2, a multivariate analysis of covariance was run to assess help-seeking intentions across factors between students with "at-risk" (N = 453), "low" (N = 484), or "normal to high" (N = 563) well-being scores. Although significant differences were found between groups on almost all help-seeking factors (except External Health Service), the differences between groups were small. However, consistently those with "normal to high" well-being demonstrated higher intention to seek help compared to "low" and "at-risk" groups. Across all groups, Personal Relations demonstrated the highest average help-seeking intention score and, in addition to supporting findings in previous literature, represents a potential "lowest hanging fruit" of help-seeking source for university students.
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Difficulties in executive functioning (EF) can result in impulsivity, forgetfulness, and inattention. Children living in remote/regional communities are particularly at risk of impairment in these cognitive skills due to reduced educational engagement and poorer access to interventions. This vulnerability has been exacerbated by the COVID-19 pandemic and strategies are needed to mitigate long-term negative impacts on EF. Here we propose a pilot trial investigating the benefits, feasibility, and acceptability of a school-based EF intervention for primary school students (6-8 years) living in regional, developmentally vulnerable, and socio-economically disadvantaged communities. Students were randomised to a digital intervention or teaching as usual, for 7 weeks. Children completed measures of EF and parents/educators completed ratings of everyday EF and social/emotional wellbeing at pre-intervention, post-intervention, and 3-month follow-up. Change in EFs (primary outcome), everyday EF, and social/emotional wellbeing (secondary outcomes) from pre- to post-intervention and pre-intervention to 3-month follow-up were examined. Feasibility and acceptability of the intervention was assessed through educator feedback and intervention adherence.Protocol Registration: The stage 1 protocol for this Registered Report was accepted in principle on 20 April 2023. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/WT3S2 . The approved Stage 1 protocol is available here: https://osf.io/kzfwn .
Subject(s)
COVID-19 , Cognition , Humans , Child , COVID-19/psychology , COVID-19/epidemiology , Pilot Projects , Male , Female , Executive Function , Pandemics , SARS-CoV-2 , Schools , Students/psychologyABSTRACT
OBJECTIVE: Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. METHOD: In this double-blind randomized controlled trial 55 children with ADHD (5-9 years) were allocated to the intervention (N = 28) or control program (N = 27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. RESULTS: Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p < .044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. CONCLUSION: Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Humans , Attention Deficit Disorder with Hyperactivity/therapy , Double-Blind Method , Male , Child , Female , Child, Preschool , Attention , Treatment Outcome , Executive FunctionABSTRACT
BACKGROUND: Emotional dysregulation, poor emotion recognition and impaired response inhibition have been highlighted as potential contributors to social difficulties in adolescents with attention-deficit/hyperactivity disorder (ADHD). It is currently unknown how these areas of impairment relate to one another; therefore, this study aims to identify the areas of emotion regulation which are associated with social difficulties in adolescents with ADHD, and determine whether emotion regulation mediates the relationship between deficits in response inhibition and emotion recognition, and social functioning, in this cohort. METHODS: Thirty Australian adolescents (Male = 21) with ADHD completed measures of response inhibition, emotion recognition, and emotion regulation. RESULTS: Positive emotion regulation was significantly associated with social difficulties. Although emotion recognition significantly predicted social difficulties, there was no relationship between emotion recognition and emotion regulation in this sample, ruling out emotion regulation as a mediator of emotion recognition and social difficulties. Whilst response inhibition was significantly correlated with positive emotion regulation, positive emotion regulation did not mediate the relationship between response inhibition and social difficulties. CONCLUSIONS: Difficulties recognising and regulating emotions appear to independently contribute to social difficulties in adolescents with ADHD. Interventions to increase emotional understanding and developing strategies to down-regulate positive emotions may be beneficial.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Emotional Regulation , Humans , Male , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Australia , Emotions/physiology , Recognition, PsychologyABSTRACT
BACKGROUND: Many interventions have been developed to address the social difficulties commonly experienced by adolescents with attention-deficit/hyperactivity disorder (ADHD), yet they are largely ineffective. OBJECTIVE: This study examined social impairment among adolescents with and without ADHD, determining whether gender, social anxiety, age, and ADHD symptom type (inattention and hyperactivity/impulsivity) and severity are associated with social impairment. METHOD: Parents and primary caregivers of adolescents (aged 13-17) with (n = 76) and without ADHD (n = 36) completed the Strengths and Weaknesses of ADHD and Normal Behavior, Social Responsiveness Scale 2nd Edition, and Spence Children's Anxiety Scale. RESULTS: Adolescents with ADHD scored significantly higher than TD adolescents across social impairment domains. ADHD symptoms were associated with severity of impairment in all domains excluding Social Motivation. Hyperactivity/impulsivity and social anxiety predicted social impairment, whereas gender did not. CONCLUSION: Adolescents with ADHD are more likely to experience social impairment than TD adolescents, and interventions targeting symptom reduction and social anxiety may improve these social impairments.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Social Behavior , Humans , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Anxiety/diagnosis , Motivation , Male , Female , Risk Factors , Psychiatric Status Rating ScalesABSTRACT
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is characterised by significant deficits in attention and inhibition. These deficits are associated with negative sequelae that emerge in childhood and often continue throughout adolescence. Despite these difficulties adolescents with ADHD often demonstrate poor treatment compliance with traditional interventions (eg, psychostimulant medication). Virtual reality (VR) presents an innovative means of delivering engaging cognitive interventions for adolescents with ADHD and offers the potential to improve compliance with such interventions. The current parallel, randomised controlled trial aims to evaluate the effects of a VR intervention (Alfi) designed to improve inhibition in adolescents with ADHD. METHODS AND ANALYSIS: A sample of 100 adolescents (aged 13-17) with elevated ADHD symptoms will be recruited from secondary schools and ADHD organisations located in the state of Victoria, Australia. Participants will be randomly assigned to either an 8-week VR intervention or a usual care control. The VR intervention involves the completion of 14 sessions, each 20 min in duration. Participants will complete computerised assessments of inhibition and risk-taking preintervention and immediately postintervention. Parents/guardians will complete online questionnaires about their child's ADHD symptoms and social functioning at each of these timepoints. The primary outcome is change in inhibition performance in adolescents who received the intervention from preintervention to postintervention compared with adolescents in the control condition. Secondary outcomes include change in risk-taking, ADHD symptoms and social functioning in adolescents who received the intervention from preintervention to postintervention compared with adolescents in the control condition. If the intervention is shown to be effective, it may offer a supplementary approach to traditional interventions for adolescents with ADHD experiencing inhibitory control difficulties. ETHICS AND DISSEMINATION: This trial has ethics approval from the Monash University Human Research Ethics Committee (HREC) (21530) and the Victorian Department of Education and Training HREC (2020_004271). Results will be disseminated through peer-reviewed journals, conference proceedings and community activities. Individual summaries of the results will be provided to participants on request. TRIAL REGISTRATION NUMBER: ACTRN12620000647932.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Central Nervous System Stimulants , Virtual Reality , Adolescent , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Humans , Parents/psychology , VictoriaABSTRACT
The aim of this study was to describe the prevalence, severity, coping strategies and precipitating factors of food insecurity in university students in a large multi-campus Australian university during the COVID-19 lockdown in 2020, in context of providing information to inform institutional support. This was a cross-sectional analysis which was part of a larger university-led research project, the Thrive@Home study conducted at Monash University during the COVID-19 pandemic. The main outcome measures included: Sociodemographic characteristics, PROMIS anxiety, PROMIS depression and the six-item US Department of Agriculture Household Food Security Survey Module. All variables were reported according to the four levels of food security status (high (H), marginal (M), low (L) and very low (VL)). Chi-squared tests were used to compare all categorical variables including demographic, mental health and food security status. A multivariable regression was conducted between food security status and mental health variables. Overall, n = 1315 students were included in the analysis. Of which, 5% were classified as having VL food security, 13% L, 14% M and 68% H. As food security worsened the likelihood of being unemployed looking for work, living alone and deteriorating physical health, diet quality and mental health increased. As food security status deteriorated the prevalence of needing to ask family or friends for food, shopping at multiple outlets for discounts, accessing emergency food relief, subsidised meals and financial assistance from organisations increased (p < 0.002). In regression models adjusting for covariates, depression (b (95%CI): VL = 7.2(4.1-10.3), L = 3.7(1.7-5.7), M = 2.0(0.1-3.8)) and anxiety (VL = 7.4(4.5-10.4), L = 3.5(1.5-5.4) and M = 2.0(0.3-3.8)) were positively associated with worsening food security. Food insecurity during COVID-19 was associated with worsening mental health. This paper provides targets for future university-led initiatives to promote student food security and supporting better access to physical and mental health services.
Subject(s)
COVID-19 , Food Supply , Humans , Universities , Cross-Sectional Studies , Pandemics , Socioeconomic Factors , COVID-19/epidemiology , Australia/epidemiology , Communicable Disease Control , Food InsecurityABSTRACT
INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning. Children with ADHD are developmentally vulnerable, with the disorder linked to emotional regulation difficulties, behavioural disturbances, as well as academic challenges. Emerging evidence suggests that children with ADHD may benefit from cognitive training interventions, including those focused on attention. This study aims to assess the immediate and long-term efficacy of an attention training intervention in children with ADHD. METHODS AND ANALYSIS: This study is a preregistered, parallel, double blind, randomised controlled trial. Participants will comprise 104 children with a diagnosis of ADHD aged 5-8 years 11 months. Participants will be randomly allocated to either an adaptive, digital game-based (1) attention training programme (intervention) or (2) a numeracy programme (control). Both programmes will be delivered on a touchscreen tablet, and children will complete five 20 min sessions per week for a 5-week period at home (25 sessions in total). Assessments of the primary outcome (ie, attention and inhibitory control) and secondary outcomes (ie, selective attention, interference control, sustained attention, inhibition, behavioural attention, impairment in everyday functioning, working memory and executive functioning) will occur at preintervention, immediately postintervention and at 3-month follow-up. Multivariate linear regression will be employed to examine primary and secondary outcomes. The data analyst will be blinded to group membership. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Monash University HREC (20495). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities. TRIAL REGISTRATION NUMBER: ACTRN12620000964910, UTN U1111-1250-2620.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Attention , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Cognition , Executive Function , Humans , Memory, Short-Term/physiology , Randomized Controlled Trials as TopicABSTRACT
Introduction: Coronavirus (COVID-19) instigated unprecedented global effects on healthcare systems, economies, employment, education, travel, and social lives. In addition to increased mental health challenges, pandemic restrictions have triggered emerging cognitive concerns. University students are at particularly high risk of adverse lockdown-related effects, yet despite the substantial adaptions to learning necessitated by COVID-19, limited research has so far focused on the cognitive consequences of the pandemic among university students. This study aimed to comprehensively examine the nature, prevalence, and correlates of subjective cognitive concerns among 972 students (Median age = 22âyears, 70% female) enrolled at Monash University, Australia, in December 2020. Methods: Students completed the online THRIVE@Monash survey, 5âweeks following prolonged lockdown in Melbourne. Using group comparisons and hierarchical binary logistic regression analyses, we examined associations between demographic and enrolment characteristics, COVID-19-related experiences and impacts (author-developed questions), self-reported anxiety and depression symptoms (PROMIS Anxiety and Depression scales), and students' perceived changes in everyday cognitive functions (author-developed questions). Results: Over 60% of students reported subjective cognitive concerns (SCCs). After controlling for anxiety and depression symptoms, students reporting more SCCs were more likely to be younger, from White/European ethnic backgrounds, and in their first year of undergraduate study. No differences in SCCs were found between male and female students. Greater worry, anxiety, or stress related to COVID-19 (e.g., infection, leaving the house, hygiene and exposure prevention, impact on physical and mental health), and time spent reading or talking about COVID-19, were generally not associated with SCCs after controlling for anxiety and depression symptoms. Discussion: These findings highlight vulnerable subgroups of students who might benefit from regular monitoring, education, and interventions to support their cognitive health during the pandemic and beyond. In addition, cognitive concerns may provide additional insight into mental health problems among students, and emphasize the importance of understanding factors that impact students' long-term academic and career success.
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BACKGROUND: The COVID-19 pandemic has contributed to a decline in mental health globally. Compared to the general population, university students have been identified as a group vulnerable to developing depression symptoms during the pandemic. Social isolation, a signature mental health consequence under physical-distancing regulations, is a known predictor of depression symptoms during the pandemic. Yet, more research is required to understand the mechanism that underpins the isolation-depression association and identify psychological factors that may attenuate the association. The current study aimed to understand the role of stress and resilience in the isolation-depression association among university students. METHODS: Data were collected from 1718 university students between 28 and 31 May 2020. Partial least squares structural equation modelling (PLS-SEM) was used to examine the mediating role of perceived stress and the moderating role of resilience in the isolation-depression association. RESULTS: We found that perceived stress partially mediated the association between social isolation and depression symptoms. Both the direct and indirect effects were moderated by participants' resilience levels. CONCLUSIONS: Social isolation during the pandemic may contribute to depression symptoms both directly and through elevated stress levels. As an internal strength, resilience may buffer the adverse effects of isolation and stress on depression symptoms. Targeted interventions including mindfulness and physical exercise training may provide promising results in reducing depression symptoms among university students and should be considered by university administrators particularly during times of imposed physical-distancing measures.
Subject(s)
COVID-19 , Depression/epidemiology , Humans , Pandemics , SARS-CoV-2 , Students , UniversitiesABSTRACT
Background: The COVID-19 pandemic lockdowns have adversely impacted children on the autism spectrum and their families, especially in Malaysia where this population is often marginalized. The current quantitative research aimed to investigate the impact of the Malaysian COVID-19 lockdown on the behavior and psychological distress of children formally diagnosed with an autism spectrum condition (ASC) as well as the psychological distress and well-being of their parents, in comparison with a typically developing (TD) control group. Methods: The children's ages ranged between 5 and 17 years. The sample included 72 ASC parent-child dyads and 62 TD parent-child dyads. The primary caregiver completed an online survey including the following: demographic and diagnostic information; ASC symptoms; children's inattention, hyperactivity/impulsivity, perceived stress, depression, and anxiety; parents' perceived stress, depression, anxiety, and well-being based on their experience pre- and mid-lockdown (March 18th to June 9th 2020) in Malaysia. Results: Among the ASC group, no significant pre- and mid-lockdown change was found in ASC symptoms (p > 0.05). There were no significant gender differences (boys/girls) in all the child scales. The 2 [diagnosis (ASC, TD)] × 2 [lockdown (pre-lockdown, mid-lockdown)] mixed-model ANOVAs revealed main effects of lockdown on children's attention, hyperactivity/impulsivity, anxiety, and parents' perceived stress, depression, and psychological well-being (p < 0.005). There was a main effect of diagnosis in all child and parent variables, except parents' perceived stress (p >0.005). However, there was no significant interaction effect between diagnosis and lockdown (p >0.005). All child behavior (inattention and hyperactivity/impulsivity) and child psychological distress (anxiety, depression, and perceived stress) were significantly correlated in both the ASC and TD groups (p < 0.005). On the other hand, only some of the parent variables were significantly correlated with child variables (p < 0.0045) in the ASC group while none of the parent variables were significantly correlated with the child variables (p > 0.005) in the TD group. Conclusion: The results provide preliminary evidence indicating negative effects of the Malaysian lockdown on both children on the autism spectrum and TD children, as well as their parents. These quantitative results will be triangulated with the qualitative interview data to provide a holistic understanding of the impact of the pandemic, informing translational policy and practice recommendations.
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BACKGROUND: The COVID-19 pandemic has posed risks to public mental health worldwide. University students, who are already recognised as a vulnerable population, are at elevated risk of mental health issues given COVID-19-related disruptions to higher education. To assist universities in effectively allocating resources to the launch of targeted, population-level interventions, the current study aimed to uncover predictors of university students' psychological wellbeing during the pandemic via a data-driven approach. METHODS: Data were collected from 3973 Australian university students ((median age = 22, aged from 18 to 79); 70.6% female)) at five time points during 2020. Feature selection was conducted via least absolute shrinkage and selection operator (LASSO) to identify predictors from a comprehensive set of variables. Selected variables were then entered into an ordinary least squares (OLS) model to compare coefficients and assess statistical significance. RESULTS: Six negative predictors of university students' psychological wellbeing emerged: White/European ethnicity, restriction stress, perceived worry on mental health, dietary changes, perceived sufficiency of distancing communication, and social isolation. Physical health status, emotional support, and resilience were positively associated with students' psychological wellbeing. Social isolation has the largest effect on students' psychological wellbeing. Notably, age, gender, international status, and educational level did not emerge as predictors of wellbeing. CONCLUSION: To cost-effectively support student wellbeing through 2021 and beyond, universities should consider investing in internet- and tele- based interventions explicitly targeting perceived social isolation among students. Course-based online forums as well as internet- and tele-based logotherapy may be promising candidates for improving students' psychological wellbeing.
Subject(s)
COVID-19 , Pandemics , Adult , Australia , Female , Humans , Male , SARS-CoV-2 , Students , Universities , Young AdultABSTRACT
There are growing concerns that increased screen device usage may have a detrimental impact on classroom behaviour and attentional focus. The consequences of screen use on child cognitive functioning have been relatively under-studied, and results remain largely inconsistent. Screen usage may displace the time usually spent asleep. The aim of this study was to examine associations between screen use, behavioural inattention and sustained attention control, and the potential modifying role of sleep. The relations between screen use, behavioural inattention, sustained attention and sleep were investigated in 162 6- to 8-year-old children, using parent-reported daily screen use, the SWAN ADHD behaviour rating scale, The sustained attention to response task and the children's sleep habits questionnaire. Tablet use was associated with better sustained attention performance but was not associated with classroom behavioural inattention. Shorter sleep duration was associated with poorer behavioural inattention and sustained attention. Sleep quality and duration did not act as mediators between screen usage and behavioural inattention nor sustained attention control. These findings suggest that careful management of the amount of time spent on electronic screen devices could have a beneficial cognitive impact on young children. The results also highlight the critical role of sleep in enhancing both behavioural attention and sustained attention, which are essential for supporting cognitive development and learning.
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Objective: This randomized controlled trial evaluated the efficacy of attention training delivered in class on cognitive attention processes, inattention, hyperactivity, working memory, and numeracy in primary school children. Method: Eight classes (n = 98 children; 5-9 years) were cluster randomized to gamified attention training, a placebo program, or a no-contact control condition. Assessments were conducted at baseline, immediately after the 5-week intervention (posttraining), and 6 months later (follow-up). Results: Posttraining, attention training was associated with reduced inattention and hyperactivity within the classroom compared with controls, and reduced hyperactivity at home compared with the no-contact control. At follow-up, reduced hyperactivity within the classroom compared with the no-contact control persisted. No effects of training on cognitive attention processes, working memory, and numeracy were observed posttraining. Conclusion: Classroom-based attention training has select benefits in reducing inattention and hyperactivity, but may not promote gains in cognitive or academic skills in primary school children.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Attention , Attention Deficit Disorder with Hyperactivity/therapy , Child , Cognition , Humans , Memory, Short-Term , SchoolsABSTRACT
Our current understanding of how the visual brain develops is based largely on the study of luminance-defined information processing. This approach, however, is somewhat limiting, since everyday scenes are composed of complex images, consisting of information characterized by physical attributes relating to both luminance and texture. Few studies have explored how contrast sensitivity to texture-defined information develops, particularly throughout the school-aged years. The current study investigated how contrast sensitivity to luminance- (luminance-modulated noise) and texture-defined (contrast-modulated noise) static gratings develops in school-aged children. Contrast sensitivity functions identified distinct profiles for luminance- and texture-defined gratings across spatial frequencies (SFs) and age. Sensitivity to luminance-defined gratings reached maturity in childhood by the ages of 9-10 years for all SFs (0.5, 1, 2, 4 and 8 cycles/degree or cpd). Sensitivity to texture-defined gratings reached maturity at 5-6 years for low SFs and 7-8 years for high SFs (i.e., 4 cpd). These results establish that the processing of luminance- and texture-defined information develop differently as a function of SF and age.
Subject(s)
Contrast Sensitivity/physiology , Image Processing, Computer-Assisted , Light , Schools , Adolescent , Adult , Child , Child, Preschool , Humans , Photic Stimulation , Young AdultABSTRACT
Even genetic disorders associated with monogenic aetiologies are characterized by complex and variable risk for poor outcomes, highlighting the need to follow trajectories longitudinally. Here, we investigated the longitudinal relationships between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms in a population at high risk for both: boys with fragile X syndrome. 59 boys with fragile X syndrome aged 3-10 years old at entry participated in this study, and were followed up one and two years after their first visit. As expected, we found strong relationships over three timepoints for ADHD symptoms (as measured by the parent-rated Conners scale) and ASD symptoms (as measured by the Social Communication Questionnaire [SCQ]). In addition, using structural equation modeling (SEM) we found that ADHD symptoms at time 2 predicted ASD symptoms at time 3, suggestive of a causal relationship. Importantly, these relationships hold when including chronological age at entry to the study, as well as when including severity of impairment as measured by IQ, and their effects on both ASD and ADHD symptoms do not reach significance. This result highlights the need to study outcomes longitudinally and it informs the comorbidity of the two symptom domains in FXS as well as their potential directionality, both of which have been little researched. In addition, our findings may suggest a future need to study how ADHD symptoms and their treatment impact individuals with ASD.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , Autistic Disorder , Fragile X Syndrome , Attention Deficit Disorder with Hyperactivity/epidemiology , Autism Spectrum Disorder/epidemiology , Child , Child, Preschool , Comorbidity , Fragile X Syndrome/epidemiology , Humans , MaleABSTRACT
A new variation of the Attention Network Task (ANT) was designed to measure the functioning of and interactions between the alerting, exogenous and endogenous visual spatial orienting, and executive control systems in young school children. Previous research has produced mixed results regarding typical functioning of the attention networks in six-year-olds; no ANT has measured the functioning of the endogenous network. This Staged ANT tested the Alerting, Exogenous, and Endogenous orienting networks in separate conditions. Two hundred and forty-seven children (average age 6 years, 103 girls) completed the task. There was no clear benefit of the alerting cue until the spatial orienting cues were introduced into the task, suggesting task complexity was needed before alerting benefits were observed. The validity effect of the exogenous cue was very strong: in contrast, the validity effect of the endogenous cue was very weak. The flanker effect was very strong. A benefit of the alerting cue was shown during both the exogenous and endogenous conditions, while a cost of the alerting cue was shown during the invalid exogenous trials. Neither the alerting nor validity effects interacted with the flanker effect. These results suggest that the alerting cue primes the exogenous and endogenous systems for the upcoming cues. Once the complexity of the task increases with the addition of the flankers, the alerting effect attenuates. The alerting and the two orienting networks interact together but the executive attention network acts independently, in children aged 6 years.
Subject(s)
Attention/physiology , Executive Function/physiology , Orientation/physiology , Child , Cues , Female , HumansABSTRACT
INTRODUCTION: Childhood inattention has been linked with poor academic outcomes, and increased lifetime social, occupational and psychiatric morbidity. Children with an acquired brain injury (ABI) are particularly susceptible to attention deficits and may benefit from interventions aimed at enhancing attention. The primary objective of this study is to evaluate the short-term efficacy of the TALI Train programme, compared with a placebo, on the outcome of attention in children with ABI. METHODS AND ANALYSIS: The study is a parallel, double-blind, randomised controlled trial. Participants will consist of 80 children with a diagnosis of ABI aged 4-9 years 11 months. Participants will be randomly allocated to either (1) TALI Train (intervention group), an adaptive game-based attention training programme, or (2) a non-adaptive placebo programme (control group). Both programmes are delivered on a touchscreen tablet, and children complete five 20 min sessions per week for a 5-week period at home. Assessment of selective, sustained and executive attention (primary outcomes), and behavioural attention, working memory, social skills and mathematics ability (secondary outcomes) will occur at baseline, post-training, and at 3-month and 6-month follow-up to assess immediate and long-term efficacy of TALI Train compared with placebo. Assessments will be completed at the Royal Children's Hospital in Melbourne, Australia. All assessments and analyses will be undertaken by researchers blinded to group membership. Latent growth curve modelling will be employed to examine primary and secondary outcomes. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Royal Children's Hospital Human Research Ethics Committee (HREC) (38132) and the Monash University HREC (17446). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities. TRIAL REGISTRATION NUMBER: ACTRN12619000511134.
Subject(s)
Adaptation, Psychological , Brain Injuries , Education/methods , Video Games/psychology , Attention , Attention Deficit Disorder with Hyperactivity/prevention & control , Brain Injuries/psychology , Brain Injuries/therapy , Child , Cognition , Double-Blind Method , Executive Function , Female , Humans , Male , Psychological Techniques , Randomized Controlled Trials as TopicABSTRACT
Impaired sustained attention is considered an important factor in determining poor functional outcomes across multiple cognitive and behavioural disorders. Sustained attention is compromised for both children with Williams syndrome (WS) and Down's syndrome (DS), but specific difficulties remain poorly understood because of limitations in how sustained attention has been assessed thus far. In the current study, we compared the performance of typically developing children (Nâ¯=â¯99), children with WS (Nâ¯=â¯25), and children with DS (Nâ¯=â¯18), on a Continuous Performance Task - a standard tool for measuring sustained attention. In contrast to previous studies, primarily focused on overall differences in mean performance, we estimated the extent to which performance changed over time on task, thus focusing directly on the sustained element of performance. Children with WS and children with DS performed more poorly overall compared to typically developing children. Importantly, measures specific to changes over time differentiated between children with the two syndromes. Children with WS showed a decrement in performance, whereas children with Down's syndrome demonstrated non-specific poor performance. In addition, our measure of change in performance predicted teacher-rated attention deficits symptoms across the full sample. An approach that captures dynamic changes in performance over assessments may be fruitful for investigating similarities and differences in sustained attention for other atypically developing populations.
Subject(s)
Attention/physiology , Down Syndrome/physiopathology , Pattern Recognition, Visual/physiology , Psychomotor Performance/physiology , Williams Syndrome/physiopathology , Child , Child, Preschool , Female , Humans , Male , Time FactorsABSTRACT
Background: Fragile X syndrome (FXS) is a common monogenic cause of intellectual disability with autism features. While it is caused by loss of the FMR1 product (FMRP), mosaicism for active and inactive FMR1 alleles, including alleles termed premutation (PM: 55-199 CGGs), is not uncommon. Importantly, both PM and active full mutation (FM: ≥ 200 CGGs) alleles often express elevated levels of mRNA that are thought to be toxic. This study determined if complete FMR1 mRNA silencing from FM alleles and/or levels of FMR1 mRNA (if present) in blood are associated with intellectual functioning and autism features in FXS. Methods: The study cohort included 98 participants (70.4% male) with FXS (FM-only and PM/FM mosaic) aged 1-43 years. A control group of 14 females were used to establish control FMR1 mRNA reference range. Intellectual functioning and autism features were assessed using the Mullen Scales of Early Learning or an age-appropriate Wechsler Scale and the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2), respectively. FMR1 mRNA was analysed in venous blood collected at the time of assessments, using the real-time PCR relative standard curve method. Results: Females with FXS had significantly higher levels of FMR1 mRNA (p < 0.001) than males. FMR1 mRNA levels were positively associated with age (p < 0.001), but not with intellectual functioning and autistic features in females. FM-only males (aged < 19 years) expressing FM FMR1 mRNA had significantly higher ADOS calibrated severity scores compared to FM-only males with completely silenced FMR1 (p = 0.011). However, there were no significant differences between these subgroups on intellectual functioning. In contrast, decreased levels of FMR1 mRNA were associated with decreased intellectual functioning in FXS males (p = 0.029), but not autism features, when combined with the PM/FM mosaic group. Conclusion: Incomplete silencing of toxic FM RNA may be associated with autistic features, but not intellectual functioning in FXS males. While decreased levels of mRNA may be more predictive of intellectual functioning than autism features. If confirmed in future studies, these findings may have implications for patient stratification, outcome measure development, and design of clinical and pre-clinical trials in FXS.