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Standardizing Attention Process Training-III for a Multisite Clinical Trial of Neuromodulation.

Jessica D Richardson1, Honey I Hubbard1, Sarah Grace Dalton2

  • 1Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM 87131, USA.

Military Medicine
|August 20, 2024
PubMed
Summary

Standardizing Attention Process Training-III (APT-III) administration is crucial for reliable results in clinical trials for mild traumatic brain injury (TBI). This study refines APT-III procedures to balance individualization with consistency across participants and sites.

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Area of Science:

  • Neuroscience
  • Clinical Psychology
  • Rehabilitation Medicine

Background:

  • Mild traumatic brain injury (TBI) affects military personnel, necessitating effective cognitive training.
  • Attention Process Training-III (APT-III) is a promising intervention but requires standardization for multi-site clinical trials.
  • The CONNECT-TBI study aims to enhance cognitive training with neuromodulation in TBI participants.

Purpose of the Study:

  • To identify and address ambiguities in Attention Process Training-III (APT-III) administration.
  • To develop standardized procedures for reliable APT-III implementation across diverse clinical settings.
  • To ensure consistency in cognitive training delivery within the CONNECT-TBI trial.

Main Methods:

  • Reviewed ten studies utilizing APT-III for administration methodologies.
  • Analyzed the APT-III manual, flagging subjective and decision-dependent aspects.
  • Developed and refined standardized task algorithms and training materials through team consensus.

Main Results:

  • Identified critical areas for standardization: dosage, adaptation, metacognitive strategy instruction, and goal attainment scaling.
  • Presented APT-III manual details, literature findings, and CONNECT-TBI's standardized solutions.
  • Developed an algorithm for adjusting training task difficulty and speed within defined parameters.

Conclusions:

  • Highlighted key areas in APT-III administration needing standardization for clinical trials.
  • Provided examples of standardization processes, rules, and materials for future research.
  • Established a balanced approach to individualization and consistency in APT-III delivery for TBI research.