Evaluation of a School-Based Attention Training Programme for Improving Concentration

January 4, 2021 updated by: Eadaoin Slattery, University of Limerick

Evaluation of a School-Based Attention Training Programme for Improving Sustained Attention: A Cluster Randomised Pilot Study

This study evaluates a school-based attention training programme for improving sustained attention in children.

Study Overview

Detailed Description

Sustained attention is an elementary attentional function that is essential for effective learning and functioning in school. Poor sustained attention is a relatively common problem in childhood with as many as 24% of children exhibiting frequent inattention. Children with attentional difficulties are at increased risk for a variety of negative educational outcomes, including lower standardised grades, dropping out of school and repeating a year. This evidence highlights the need to develop interventions aimed at enhancing students' sustained attention capacity. Current school-based interventions for student attention problems include intervention strategies targeting behavioural, academic and self-regulation. However, none of these interventions aim to enhance attentional capacity. Attention network training (or attention training) has been identified as a potentially promising intervention for enhancing attentional capacity. This pilot study aimed to evaluate the preliminary efficacy of a theory-driven attention training programme, Keeping Score!, in improving students' capacity to sustain attention in a school setting. Training was based on sustained updating. Children engaged this process by mentally keeping score during an interactive face-to-face game without external aids. The study used a cluster randomised design. Students (N = 36) were assigned based on their class group to either the 6-week attention training programme (n = 18) or an active control (n = 18). Outcome measures were assessed at baseline, immediately after training and an approximate 6-week follow up.

Study Type

Interventional

Enrollment (Actual)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Limerick, Ireland
        • Department of Psychology, University of Limerick

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

9 years to 11 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • 4th and 5th class students
  • aged 9 to 11 years
  • parent consent and participant assent

Exclusion Criteria:

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Attention Training

Engaged in sustained updating by mentally keeping score during an interactive game without written or verbal aids.

Participants received 15-minute sessions, three times a week for six weeks (18 sessions in total).

The training was delivered face-to-face in groups of three participants. Participants were involved in a game of table tennis with two players and one spectator. The roles were rotated every 5 minutes so that each participant experienced 10 minutes of play and 5 minutes of observation. The game was played as normal with one point awarded to the player for every score achieved. All 3 players were asked to keep the score of the game in their minds during each 5-minute round. Participants had two objectives 1) to play and win the game and 2) to silently keep the score of the game. The researcher watched the game and accurately kept score, using a notepad. At the end of every 5-minute round, the researcher paused play and asked each child to write down the score they were holding in their mind. The researcher then revealed the true score, asked participants to swap roles and commence another round.
Active Comparator: Active Control

Played the same interactive game as the attention training group without the requirement of mentally keeping score.

Participants received 15-minute sessions, three times a week for six weeks (18 sessions in total).

The control group was the same as the training group except for the core training mechanism; children were not required to mentally keep score. The researcher kept score by continually calling out the updated score as each point was won. The observing child was simply told to wait his/her turn.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in scores on the Vigil subtest of the Test of Everyday Attention for Children - Second Edition (TEA-Ch2).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Vigil subtest of the TEA-Ch2 is a measure of sustained attention. Participants were required to count slow, irregularly paced stimuli. Participants completed 10 trials. The outcome variable was the total number of correct trials. Higher scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in scores on the Cerberus subtest of the Test of Everyday Attention for Children - Second Edition (TEA-Ch2).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Cerberus subtest of the TEA-Ch2 is a measure of sustained attention. Participants were required to listen to short clips and respond (press the spacebar) to a target auditory stimulus while ignoring other sounds. Participants completed 15 trials. The outcome measure was mean reaction time in msecs weighted for accuracy. Lower scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in scores on the Sustained Attention to Response Task (SART) subtest of the Test of Everyday Attention for Children - Second Edition (TEA-Ch2).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The SART subtest of the TEA-Ch2 is a measure of sustained attention. Participants were required to respond (press the spacebar) to every shape (go-trial) that appeared on screen but not to respond to a triangle (no-go trial). There were 20 no-go trials. The outcome measure was errors of commission (no-go trial responses). Lower scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in scores on the Digit Span Backwards subtest of the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Digit Span Backwards subtest is a measure of working memory. Participants were required to repeat a dictated string of numbers in the reverse order. The task was discontinued when the participant failed to answer both trials of a set correctly. The outcome measure was the total number of correctly recalled trials. The maximum total score is 18. Higher scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in scores on the Operation Span subtest of the Adaptive Composite Complex Span (ACCES).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Operation Span subtest is a measure of working memory. Participants were required to evaluate maths problems while memorising letters. Participants completed 6 trials. The number of stimulus-problem pairs within a trial varied between two and eight. The outcome measure was the total number of stimuli correctly recalled. Higher scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in scores using the Symmetry Span subtest of the Adaptive Composite Complex Span (ACCES).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Symmetry Span subtest is a measure of working memory. Participants were required to evaluate whether geometric shapes were symmetrical while remembering spatial locations. Participants completed 6 trials. The number of stimulus-problem pairs within a trial varied between two and eight. The outcome measure was the total number of stimuli correctly recalled. Higher scores indicate a better outcome .
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in scores on the Digit Span Forward subtest of the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The Digit Span Forwards subtest is a measure of short-term memory. Participants were required to repeat a dictated string of numbers in the same order. The task was discontinued when the participant failed to answer both trials of a set correctly. The outcome measure was the total number of correctly recalled trials. The maximum total score is 18. Higher scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
Change in parent ratings of executive function behaviour on the Behaviour Rating Inventory of Executive Function - Second Edition (BRIEF-2).
Time Frame: Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.
The BRIEF-2 assesses everyday behaviours associated with executive function in the home environment. Parents rated 63 items on a three-point Likert scale (0 = never, 1 = sometimes and 2 = often). The following indices were used: Behaviour Regulation Index (BRI), Emotion Regulation Index (ERI), Cognitive Regulation Index (CRI) and Global Executive Composite (GEC). Lower scores indicate a better outcome.
Baseline (pre-training), post-training at approximately 6 weeks after baseline and study completion at approximately 12 weeks after baseline.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Principal Investigator: Eadaoin J Slattery, M.Sc., University of Limerick
  • Study Director: Laura P McAvinue, PhD, University College Dublin / University of Limerick
  • Study Director: Patrick Ryan, D.Clin.Psych, University of Limerick
  • Study Director: Donal G Fortune, PhD, University of Limerick

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 26, 2018

Primary Completion (Actual)

May 30, 2019

Study Completion (Actual)

May 30, 2019

Study Registration Dates

First Submitted

December 23, 2020

First Submitted That Met QC Criteria

January 4, 2021

First Posted (Actual)

January 7, 2021

Study Record Updates

Last Update Posted (Actual)

January 7, 2021

Last Update Submitted That Met QC Criteria

January 4, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The anonymised dataset is available on the Open Science Framework (OSF).

IPD Sharing Time Frame

Available from 23/11/2020

IPD Sharing Access Criteria

Data is publicly available

IPD Sharing Supporting Information Type

  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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