Randomised Controlled Trial of Gaze-Based Attention Training Intervention for Infants With a Family History of Attention Deficit Hyperactivity Disorder: Follow-up Outcomes at 2 and 3 Years.

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.