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Gaze in Action: Head-mounted Eye Tracking of Children's Dynamic Visual Attention During Naturalistic Behavior
Published on: November 14, 2018
Randomised Controlled Trial of Gaze-Based Attention Training Intervention for Infants With a Family History of
Amy Goodwin1, Emily Jh Jones1,2, Tony Charman1
1King's College London, London, UK.
Insights
This study followed infants who received attention training for ADHD traits. The training did not show significant long-term benefits for ADHD behaviors or attention control in children up to age three.
Area of Science:
- Developmental Psychology
- Neuroscience
- Pediatrics
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with early emerging characteristics.
- Infant attention training aims to mitigate early ADHD traits.
- Previous trials showed no immediate endpoint differences.
Purpose of the Study:
- To examine longer-term effects of computerised gaze-contingent attention training.
- To assess outcomes at 2 and 3 years of age in infants with a family history of ADHD.
Main Methods:
- Follow-up study of a randomized controlled trial.
- Primary outcome: parent-reported early ADHD traits.
- Secondary outcomes: parent/researcher ratings of behavior, inhibitory control, attention, and eye-tracking measures.
Main Results:
- No significant intervention effect on parent-rated ADHD behaviors at follow-up (ES -0.28).
- No significant differences in secondary parent- or researcher-rated child behavior or eye-tracking attention outcomes.
- Trends for positive effects on parent-rated inhibitory control (ES 0.42) and a composite eye-tracking measure (ES 0.40) were observed but not statistically significant.
Conclusions:
- Conducting experimental trials for early ADHD characteristics in infancy is feasible.
- The attention training intervention did not yield significant differences in ADHD behaviors or attention control.
- Further research and modification of attention training are warranted to explore its potential as a pre-emptive intervention for infants at risk for ADHD.
Objective:
A previous randomised controlled trial of a computerised gaze-contingent attention training for 9-to-16-month infants with a family history of ADHD (intervention, n = 20; control, n = 23) found no endpoint differences on the primary outcome (an eye-tracking composite score of infant attention) nor on secondary outcomes (parent and observer ratings of infant attention in naturalistic contexts).
Method:
Here, we report follow-up at age 2 and 3 years to examine whether there are longer-term effects of the training. The pre-specified primary outcome was parent-reported early ADHD traits. Secondary outcomes included parent-report of inhibitory control and attention; researcher-rated observational measures of attentiveness, activity level and inhibition; and eye-tracking measures of cognitive control, attention disengagement and sustained attention.
Results:
At follow-up there was no intervention effect on the primary outcome parent-rated ADHD behaviours (effect size [ES] -0.28, 95% CIs -0.95 to 0.39). Secondary parent- and researcher-rated child behaviour and eye-tracking attention outcomes also did not significantly differ between the groups. The largest positive, albeit non-significant, effects were for the secondary outcomes parent-rated inhibitory control (ES = 0.42 (95% CIs -0.09 to 0.94) and the composite eye-tracking measure (ES = 0.40 (95% CIs -0.15 to 0.95).
Conclusions:
We demonstrate the feasibility of conducting experimental trials targeting early emerging ADHD characteristics in infancy. The intervention did not lead to significant differences in parent- or researcher-rated early ADHD behaviours or eye-tracking measures of attention control. However, the trend for long-term effects on CBQ inhibition, the attention composite and sustained attention justifies further interest. Further development and modification of the attention training may be necessary to test whether the approach holds promise as a potential pre-emptive intervention for infants with an elevated likelihood of ADHD.
