Attention Training in Children with Sensory Processing Disorder

Friday, May 13, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
J. A. Anguera1, A. Brandes-Aitken2, C. Rolle3, B. Wu4, E. Martucci5, J. Bower5, A. Gazzaley6 and E. J. Marco2, (1)Neurology, UCSF SNAP, San Francicso, CA, (2)University of California in San Francisco, San Francisco, CA, (3)Stanford University, Palo Alto, CA, (4)Neurology, UCSF SNAP, San Francisco, CA, (5)Akili Interactive, Boston, MA, (6)Neurology, UCSF, San Francisco, CA

Sensory Processing Disorders (SPD) negatively affect a child’s ability to process incoming stimuli and can disrupt cognitive and social development.  It has been estimated that 40% of children with SPD will meet diagnostic criteria for Attention Deficit and Hyperactivity Disorder (ADHD). Previously, we have documented baseline deficits in response time variability on measures of sustained attention in our SPD cohort.



In the current study, we aimed to determine if training with an interactive digital game-like tool (Project: EVOTM, or EVO) would improve attention in children with SPD relative to age-matched controls. 


We recruited 19 neurotypical children (12 female; mean age 9.6 +/- 1.4), 17 children with SPD+ADHD traits (6 female; mean age 10.0+/- 1.5) and 13 children with SPD-only (6 female, mean age 10.5 +/- 1.5) through the UCSF Sensory Neurodevelopment and Autism Program. All children played EVO at least 20 times over a one-month period for approximately 30 minutes each session. During these sessions, children were required to steer their avatar through complex river-like paths while simultaneous shooting at targets while ignoring distractors.  Pre and post play, we assessed measures of attention on a game-like platform (NeuroRacer), a well-recognized lab based assessment of attention (TOVA), a neurophysiological measure of cognitive control (Midline Frontal Theta using EEG), and a parent report measure of inattention (Vanderbilt).



Using an ANOVA analysis, we found a significant main effect by visit (pre and post training) for response time on NeuroRacer and response time variability on the TOVA (F= 21.46 p<.000 and F=6.04, p=.017, respectively), but no Group by Visit interaction.  Midline frontal theta (MFT) power during NeuroRacer play did show a significant group by visit interaction, with follow-up tests revealing that only the children with SPD and ADHD traits showed increased MFT power following the month long training (F=5.72, p=.007). On the parent report measure of inattention (Vanderbilt), we also found a significant group by visit interaction (F=6.40, p=.004), with follow-up tests revealing that only the SPD+ADHD children demonstrated a reduction in symptoms of inattention. Critically, we observed a significant relationship between increased MFT power and improved inattention via the Vanderbilt measure (r=.427, p=.015).


In conclusion, the Project: EVOTM training study supports the benefit of dedicated attention based training for some children with SPD, with evidence of brain plasticity and impact on real world function.  It highlights the importance of detailed cognitive assessment of attention in children with SPD and other neurodevelopmental conditions in order to personalize a treatment approach with cognitive training tools.