Who Benefits from Cognitive Training with Neurotracker?: Training Attention in Students with Autism Spectrum Disorder and Other Neurodevelopmental Disorders

Background:  Cognitive remediation involves targeting specific processes to reduce cognitive deficits, such as attention-related difficulties (Sonuga-Barke et al., 2014). For example, training attention is achieved by repeated practice on tasks that can best isolate attention (Willis & Schaie, 2009). A previous school-based study found that training with a multiple object tracking paradigm (NeuroTracker) improved performance on a separate, clinically validated measure of attention, for students diagnosed with a neurodevelopmental disorder (Tullo, Guy, Faubert, & Bertone, 2016). With Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and Intellectual Disability exhibiting different profiles of attention (Antshel et al., 2013), an examination of which clinical profile benefits most from visuo-attentive NeuroTracker training can provide additional information to tailor cognitive remediation programs from a needs-based perspective.

Objectives:  We assessed the efficacy of an attention training program using the NeuroTracker task, an adapted three-dimensional multiple object tracking paradigm found to be accessible to children and adolescents diagnosed with ASD or another neurodevelopmental disorder. Furthermore, we explored the effect of training to assess differences regarding improvements after NeuroTracker training for students diagnosed with ASD compared to those diagnosed with other neurodevelopmental disorders.

Methods: One hundred and twenty-nine students were included in the study (M_age = 13.24). All participants had a primary diagnosis of either ASD (n = 43), or any other neurodevelopmental disorder (n = 86; i.e., ADHD, Intellectual Disorder, genetic-based syndromes). A pre-assessment measure of attention was obtained for all participants via the Conners Continuous Performance Task (CPT-3) and then all participants were equally and randomly into; the experimental NeuroTracker training group (n = 43, n_ASD = 16), active control group (n = 43, n_ASD = 9) playing a strategy-math game: 2048, or treatment as usual group (n = 43, n_ASD = 25). Both experimental and active control groups trained on their respective tasks every other day for a total of 15 training sessions. Post-training performance on the CPT-3 was compared to initial CPT-3 performance to detect an improvement in attention.

Results: Collectively, pre-assessment scores on the CPT-3 revealed that all students had deficits in attention. Results from the training results showed a significant difference in the change in CPT-3 that was specific to the experimental, NeuroTracker group. Training by diagnostic group revealed that NeuroTracker performance doubled from the first to the last (fifteenth) training session for both the ASD and non-ASD groups. Furthermore, there was no significant difference between change in CPT-3 scores after training with NeuroTracker between the ASD and non-ASD groups. This demonstrates that all participants in the experimental group benefitted equally from training with NeuroTracker, regardless of their clinical profile.

Conclusions: Our findings demonstrate that attention can be improved for students with ASD using the non-verbal, visuo-attentive NeuroTracker task. Furthermore, our findings demonstrate that training with NeuroTracker can benefit all students with problematic levels of attention, regardless of primary diagnosis. These results suggest that the Neurotracker training program is accessible and effective for children and adolescents with a neurodevelopmental condition that is independent of cognitive status and diagnostic profile.