Improving Cognition and Behavior in Pediatric Cancer Survivors Using a Novel Mindful Attention Training

University of California, San Francisco

Overview

This pilot study will evaluate the cognitive and behavioral outcomes of using a novel, adaptive attention training in pediatric cancer survivors.

Pediatric cancer survivors (PCS) often experience attentional difficulties that have downstream effects on their quality of life, academic achievement, and future occupational attainment. As such, the primary goal of this project is to examine the outcomes of a novel, mindful attention training in this population and assess the feasibility of recruitment, retention, and adherence. Specifically, PCS will be randomly assigned to one of two adaptive attention training groups ('Engage') and complete tasks on the device for up to 8 weeks. Participants will also complete pre- and post-training assessments of cognition and behavior. An additional cohort of no-contact participants will be asked to complete the assessments at baseline and end of study only to assess the feasibility and reliability of the assessment measures. This cohort will be enrolled separately and not randomized. The investigators hypothesize that completion of 'Engage' training for the randomized cohorts will result in enhanced attentional control beyond the active comparator group that extends to other aspects of cognition in PCS.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Conditions

Pediatric Cancer

Interventions

Adaptive Attention TrainingBEHAVIORAL

The training is comprised of a time-based titration of rich audiovisual and sparse audio interactive environments. Training progressively transitions the participants from an immersive and rapid reward setting to a less immersive, sensory impoverished, and slower reward setting. Further, the participants' actions require delayed gratification decisions to accomplish play in the sparse setting, building fronto-parietal control through sustained attention and suppression of ventral-striatal reward impulses.

QuestionnairesBEHAVIORAL

Computer based assessments measuring attention, memory, daily habits, and mental health

Eligibility

Sex: ALLMin age: 7 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age 7-17 at the time of enrollment. 2. Able to understand study procedures and to comply with them for the entire length of the study. 3. Ability of individual and legal guardian/representative to understand a written informed consent document, and the willingness to sign it. 4. Normal or corrected-normal vision and hearing. 5. English language fluency (minor participant and parent/guardian). 6. Received radiation therapy to the brain or neck between age 7-17. 7. Patients not on current cancer-related treatment (except supportive care) or those on other current treatments that would not hinder study participation. Patients currently on cancer-related treatments will be discussed with the study team (co-PI Mueller). Exclusion Criteria: 1. Contraindication to any study-related procedure or assessment. 2. Motor/perceptual difficulties that prevent computer or tablet use. 3. Current cancer-related treatments that would impact the ability to participate in the study (e.g., current inpatient chemotherapy or intrathecal chemotherapy). Patients on other current treatments will be discussed with the study team (co-PI, Dr. Mueller)

Outcomes

Primary Outcomes

Proportion of participants who complete study

The proportion of participants who completed the study procedures will be reported by study cohort.

Time frame: Up to 8 weeks

Secondary Outcomes

Change in mean performance on a Continuous Performance Task (CPT) over time

The CPT is a 23-minute task, where participants are instructed to respond to target stimuli (squares at the top of the screen) and withhold responses to non-target stimuli (squares at the bottom of the screen). Performance will be quantified as: (1) mean reaction times, (2) standard deviation of reaction times (RTV), and (3) d-prime (comparing correct target detections or 'hits' to incorrect non-target detections or 'false alarms').

Time frame: Up to 8 weeks

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.