Gold standard of clinical studies

Take, for example, TALi’s attention training program—TALi TRAIN—that has been assessed in a rigorous, double-blind, randomised control trial, considered the ‘gold standard’ method of assessing interventions.

Kirk, H., Gray, K., Ellis, K., Taffe, J., & Cornish, K. (2016) Journal of Child Psychology and Psychiatry

Study-design-and-participants

Study design and participants

The trial for validated TALi TRAIN involved 75 children who had severe attention difficulties as a consequence of underlying neurodevelopmental disorders, such as Autism Spectrum Disorder, Down Syndrome and non-specific Intellectual Disability. Children were randomly assigned to use TALI TRAIN or a non-adaptive control program that was also delivered on a touchscreen platform. Children in both groups used their assigned program five times a week for a five-week period.

Study-design-and-participants
Selective-attention-accuracy

Results of the trial

After five weeks of using TALi TRAIN, children showed greater improvements in their ability to select relevant information and filter out distractors (Selective Attention), compared to children who used a control program for the same length of time. These attentional improvements were still present three months after the children had stopped using the program. Additionally, TALi TRAIN was shown to promote benefits in untrained academic skills, such as numeracy, at the three-month follow-up assessment.

Implications

Implications

These findings have considerable implications given the high number of children with attention difficulties currently entering the education system at a considerable disadvantage, struggling to remain, let alone thrive, in an inclusive setting.

Implications

Research highlights

 

Gamified Assessment of Attention in Early Childhood: A Large-Scale Validation Trial

TALi Health Pty Ltd.

Abstract:

Deficits in attentional capabilities lead to a range of negative life outcomes including increased risk of lowered educational attainment and mental health issues. Given that, there have been numerous attempts to measure attentional skills in early childhood with the intent of early intervention and diminishing the negative life-long consequences of attention difficulties. These include objective and subjective measures of a range of attentional domains. TALi DETECT is an app that has been designed to objectively assess several key attentional domains in young children. It uses a modern game-based approach to ensure participation on behalf of each child and consists of 7 literature-based cognitive tasks known to measure Selective Attention, Sustained Attention and Executive Attention. In this study three important psychometric characteristics of DETECT, as an attention assessment tool, were investigated:

  • Validity
  • Reliability
  • Developmental sensitivity

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Cognitive training as a resolution for early executive function difficulties in children with intellectual disabilities

Kirk, H., Gray, K., Riby, D., & Cornish, K. (2015) Research in Developmental Disabilities

Abstract:

Core executive functions (EF) such as attention, and working memory have been strongly associated with academic achievement, language development and behavioral stability. In the case of children who are vulnerable to cognitive and learning problems because of an underlying intellectual disability, EF difficulties will likely exacerbate an already compromised cognitive system. The current review examines cognitive training programs that aim to improve EF, specifically focusing on the potential of this type of intervention for children who have intellectual disabilities. We conclude that despite considerable discrepancies regarding reported intervention effects, these inconsistencies can be attributed to flaws in both program and study design. We discuss the steps needed to address these limitations and to facilitate the advancement of non-pharmaceutical interventions for children with intellectual disabilities.

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Computerised attention training for children with intellectual and developmental disabilities: a randomised controlled trial

Kirk, H., Gray, K., Ellis, K., Taffe, J., & Cornish, K. (2016) Journal of Child Psychology and Psychiatry

Abstract:

This study reviewed existing cognitive training programs that aim to improve cognitive and behavioural functions, and gauged any potential benefits that may be offered to children with intellectual disorders.

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Impact of Attention Training on Academic Achievement, Executive Functioning, and Behavior: A Randomized Controlled Trial

Kirk, H., Gray, K., Ellis, K., Taffe, J., & Cornish, K. (2017) American Journal on Intellectual and Developmental Disabilities

Abstract:

Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4–11 years) were randomized to either an attention training (n = 38) or control program (n = 38). Both programs were completed at home over a 5-week period. Outcome measures assessed literacy, numeracy, executive functioning, and behavioral/emotional problems, and were conducted at baseline, post-training, and 3-month follow-up. No training effects were observed at post-training; however, children in the training group showed greater improvements in numeracy skills at the 3-month follow-up. These results suggest that attention training may be beneficial for children with IDD; however, the modest nature of the intervention effects indicate that caution should be taken when interpreting clinical significance.

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Gamified attention training in the classroom in typically developing children: A cluster-randomized controlled trial

Kirk, H., Spencer-Smith, M., Wiley, J., & Cornish, K. (2019) Journal of Attention Disorders

Abstract:

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.

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