Computerized Attention Functions Training Vs. Executive Functions Training for Children with ADHD (AFT-EFT-ADHD)

Tel Aviv University

Status: Completed

Conditions: Attention Deficit Hyperactivity Disorder

Treatments: Other: Executive Functions Training (EFT); Other: Attention Functions Training (AFT)

Study type: Interventional

Funder types: Other

Identifiers

NCT06657469

12123944

Details and patient eligibility

About

The goal of this clinical trial was to compare the effectiveness of two computerized neurocognitive training programs for children with Attention Deficit/Hyperactivity Disorder (ADHD) and to examine their impact on attention functions, executive functions, academic performance, and behavior. The main questions this study sought to answer were:

How does Attention Functions Training (AFT) compare to Executive Functions Training (EFT) in improving cognitive abilities related to attention and executive functions in children with ADHD? What are the effects of these programs on academic performance and behavior? Researchers compared the outcomes of the AFT group, the EFT group, and a passive control group, in order to determine which program was more effective across these domains.

Participants completed computerized training sessions focused on attention or executive functions twice a week for nine weeks. They also underwent cognitive, academic, and behavioral assessments at baseline, after the training, and at follow-up.

Full description

This randomized controlled trial aimed to investigate and compare the effects of two distinct computerized neurocognitive training programs on children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). The two interventions, Attention Functions Training (AFT) and Executive Functions Training (EFT), were designed to target different cognitive domains. The AFT program focused on improving sustained, selective-spatial, orienting, and executive attention, while the EFT program aimed at enhancing working memory, cognitive flexibility, and problem-solving abilities.

A total of 80 children with ADHD, aged 8-13 years, were randomly assigned to one of three groups: AFT, EFT, or a passive control group. Each training program included twice-weekly sessions over nine weeks. Participants underwent comprehensive assessments at three time points: baseline (pre-intervention), immediately after the intervention, and at a three-month follow-up. The assessments covered cognitive functions, academic skills, and behavioral symptoms as reported by parents.

The study employed repeated measures ANOVA to analyze the effects of the interventions. Primary outcome measures included improvements in attention and executive functions, with secondary measures focused on academic performance and parent-rated behavioral symptoms. Both short-term and long-term effects were assessed to evaluate the persistence of any observed improvements.

Enrollment: 80 patients

Sex: All

Ages: 8 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ADHD

Exclusion criteria

• Coexisting diagnosis of other mental illness or neurological disorder (with the exception of ADHD and Learning Disabilities); previous serious head injury; uncorrected vision; additional developmental, sensory or motor issues; and if they are participating in other non-pharmacological treatment interventions specifically for ADHD (e.g., neurofeedback, cognitive-behavioral therapy, etc.).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 3 patient groups

Attention Functions Training (AFT) Group

Experimental group

Description:

The AFT group used two training tasks from the Cogmission software: A Conjunctive Continuous Performance Task (CCPT) designed to practice sustained attention, and a Go/No-go task, designed to practice response inhibition. This group also used three training tasks from the Computerized Progressive Attention Training (CPAT) program: (1) Conjunctive Visual Search Task, designed to improve selective-spatial attention; (2) Combined Orienting and Flanker Task, designed to improve orienting of attention; and, (3) Global-Local Task, designed to improve executive attention - conflict resolution. Each of the tasks consists of a broad hierarchy of difficulty levels, and the transition between them occurs after consistent improvement was obtained and performance reached a plateau at a given difficulty level.

Treatment:

Other: Attention Functions Training (AFT)

Executive Functions Training (EFT)

Experimental group

Description:

The EFT group used a computerized version of the Set game. Set is a pattern-recognition card game where players must identify sets of three cards that share or differ in specific attributes, such as color, shape, or number. It was used to train cognitive flexibility. In addition, this group used four computer games to train problem-solving. Three of them were designed by Leo De Sol Games and were based on familiar games: (1) Rush Hour; (2) Pipes/Plumber; and (3) Sliding Puzzle. The fourth game, Thinkrolls Kings \& Queens by Avokiddo, is a challenging adventure puzzle game that incorporates logic and physics, requiring players to navigate mazes and overcome obstacles using reasoning. Additionally, three games developed by Mindware Consulting Inc. were used to train working memory based on well-known paradigms in the field.

Treatment:

Other: Executive Functions Training (EFT)

Passive Control Group

No Intervention group

Description:

Participants in this group did not receive any active intervention during the study period. They were assessed at the same time as the other groups-before the intervention and immediately after. This group enabled us to rule out spontaneous developmental effects, as well as learning and familiarity effects that may result from repeated exposure to the assessment tasks.