School of Nursing & Midwifery, Queen's University Belfast, MBC, Belfast, Northern Ireland, United Kingdom.
Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
PLoS One. 2022 Sep 22;17(9):e0273767. doi: 10.1371/journal.pone.0273767. eCollection 2022.
Very preterm (VP) infants (born 28 to <32 weeks of gestation) are at risk of cognitive delays and lower educational attainments. These risks are linked to anomalies in attention and information processing that emerge in the first years of life. Early interventions targeting attention functioning may equip VP infants with key building blocks for later attainments.
We tested the feasibility of a randomised trial where VP infants took part in a computerised cognitive procedure to train attention control. Ten healthy VP infants aged approximately 12 months (corrected age) and randomly allocated with 1:1 ratio to the training (interactive computerised presentations) or an active control procedure completed the study. Before and after the training programme, participating infants completed a battery of screen-based attention tests, naturalistic attention and communication tasks, and temperament assessments. In a previous study we analysed the data concerning feasibility (e.g. recruitment and retention). In the paper presented here we considered the infants' performance and used Bayesian regression in order to provide credible treatment estimates considering the data collected.
Estimates indicate moderate treatment effects in visual memory: compared to controls, trained infants displayed improvements equivalent to 0.59 SD units. Trained infants also improved in their abilities to attend to less salient stimuli presentations by 0.82 SD units, compared to controls. However, results did not indicate relevant gains in attention habituation or disengagement. We also reported moderate improvements in focused attention during naturalistic tasks, and in directing other people's attention to shared objects.
The results warrant further investigation concerning the effectiveness of training attention control in VP infants, extending this line of research beyond our small and homogeneous sample of healthy VP infants. This study also emphasises the utility of Bayesian approaches in estimating potentially relevant effects in small samples or exploratory studies. The scope for further research on early attention control training is discussed in light of studies indicating VP children's susceptibility to positive environmental inputs.
Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).
极早产儿（VP）（出生于 28 周到<32 周妊娠）存在认知延迟和教育程度较低的风险。这些风险与生命最初几年出现的注意力和信息处理异常有关。针对注意力功能的早期干预可能会为 VP 婴儿提供后期获得的关键基石。
我们测试了一项随机试验的可行性，其中 VP 婴儿参加了一项计算机认知程序来训练注意力控制。10 名健康的 VP 婴儿（校正年龄约 12 个月）随机分为 1:1 比例的训练（交互式计算机呈现）或主动对照程序完成了研究。在培训计划之前和之后，参与的婴儿完成了一系列基于屏幕的注意力测试、自然注意力和沟通任务以及气质评估。在之前的研究中，我们分析了可行性（例如招募和保留）的数据。在本文中，我们考虑了婴儿的表现，并使用贝叶斯回归来提供可信的治疗估计，同时考虑了收集到的数据。
估计表明视觉记忆方面的中等治疗效果：与对照组相比，训练组婴儿的表现提高了相当于 0.59 个标准差单位。与对照组相比，训练组婴儿对不太明显的刺激呈现的注意力也提高了 0.82 个标准差单位。然而，结果并未表明注意力习惯化或脱离方面有相关收益。我们还报告了在自然任务中专注注意力和引导他人关注共享对象方面的适度改善。
结果证明了在 VP 婴儿中训练注意力控制的有效性值得进一步研究，将这一研究领域扩展到我们健康的 VP 婴儿小而同质的样本之外。本研究还强调了贝叶斯方法在估计小样本或探索性研究中潜在相关效应的实用性。考虑到表明 VP 儿童对积极环境输入敏感的研究，进一步研究早期注意力控制训练的范围进行了讨论。
注册号：NCT03896490。在临床试验方案注册和结果系统（clinicaltrials.gov）上进行了回顾性注册。
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