Project Summary Attention deficit/hyperactivity disorder (ADHD), a highly prevalent (5-11% of children 4-17 years in 2011) and persistent disorder, is associated with cognitive deficits that contribute to poor educational outcomes in ADHD. Critically, leading treatment strategies in ADHD are ineffective at improving educational outcomes. Lacking, however, is the assessment of attention deficits in real-life contexts, a key piece to understanding how these deficits impede learning opportunities in the moment (such as in the classroom) and, conversely, how they can be supported by making changes within the child’s environment. In this project, we will develop an attention assessment tool using portable electroencephalography (EEG) recordings, performed in real-time in the classroom. As part of Aim 1 we will validate the technique against (a) visual coding of on-task performance (the current standard in the field), (b) simulated classroom recordings, (c) laboratory based metrics of attention, and, (d) scores of academic achievement. In Aim 2, we collect EEG attention metrics across different types of typical classroom activities – to test if particular context (whole class, small group, individual) and instructional attention management (teacher-managed vs child-managed) preferentially facilitate attention in the classroom in children with attention deficits. The project emphasizes a theoretical shift from laboratory-based to in-classroom evaluation of attention, and underscores the importance of contextual factors that affect real-life outcomes like learning in school. In future studies, we will use the developed tools to, (i) test the efficacy of proposed classroom accommodations for ADHD (e.g., high stimulation, structure, minimal delay/idle time, reward), and (ii) test the feasibility of this tool to improve treatment monitoring by providing more accurate feedback and treatment adherence when adapted for at-home use.

Project Narrative This project will develop a validated, brain-signal based tool to measure attention in real-life settings, such as in the classroom. In relevance to public health, this effort will help to identify contextual factors (such as activity type or duration) that facilitate or hinder learning in children with deficits of attention, and, when adapted for home use, will support treatment monitoring and adherence.