A pilot study to determine the feasibility of enhancing cognitive abilities in children with sensory processing dysfunction

Abstract

Children with Sensory Processing Dysfunction (SPD) experience incoming information in atypical, distracting ways. Qualitative challenges with attention have been reported in these children, but such difficulties have not been quantified using either behavioral or functional neuroimaging methods. Furthermore, the efficacy of evidence-based cognitive control interventions aimed at enhancing attention in this group has not been tested. Here we present work aimed at characterizing and enhancing attentional abilities for children with SPD. A sample of 38 SPD and 25 typically developing children were tested on behavioral, neural, and parental measures of attention before and after a 4-week iPad-based at-home cognitive remediation program. At baseline, 54% of children with SPD met or exceeded criteria on a parent report measure for inattention/hyperactivity. Significant deficits involving sustained attention, selective attention and goal management were observed only in the subset of SPD children with parent-reported inattention. This subset of children also showed reduced midline frontal theta activity, an electroencephalographic measure of attention. Following the cognitive intervention, only the SPD children with inattention/hyperactivity showed both improvements in midline frontal theta activity and on a parental report of inattention. Notably, 33% of these individuals no longer met the clinical cut-off for inattention, with the parent-reported improvements persisting for 9 months. These findings support the benefit of a targeted attention intervention for a subset of children with SPD, while simultaneously highlighting the importance of having a multifaceted assessment for individuals with neurodevelopmental conditions to optimally personalize treatment.

Fig 1. CONSORT flowchart for experiment 1 and experiment 2.

Fig 2. Comparison of performance on behavioral measures.

(A) Response time and (B) response time variability revealing attention-related deficits in the SPD_+IA group compared to the SPD and TDC groups. Error bars indicate standard error of the mean. * = p≤ .05, ** =.p≤ .01, dashed brackets = p≤ .1.

Fig 3. Comparison of neural activity during perceptual discrimination task.

Bar graphs represent averaged MFT power between 280-320ms post target stimulus. Circles on heat maps present neural activity at the location and time of interest (4–7 Hz; 280-320ms). Error bars indicated standard error of the mean. * = p≤ .05).

Fig 4. Transfer effect on behavioral and parent report measures.

Pre and post (A) response time (B) and response time variability on behavioral tasks revealing within group change. Error bars indicate standard error of the mean. Within group main effects of session are designated as significant by stars: * = p≤ .05, ** =.p≤ .01. Sun symbols indicate statistically significant instances where SPD_+IA post-training performance was equivalent to or better than the TDC group prior to training. (C) Vanderbilt parent report inattention change bar plot (calculated by pre-post marginal means) and line plots revealing the significant group x session interaction. Error bars indicate standard error of the mean. All group x session interaction effects are designated as significant by stars (* = p≤ .05, ** =.p≤ .01) on bar graph.

Fig 5. Transfer effects related to neural activity.

(A) Neural midline frontal theta power pre and post training, (B) change in power (calculated using post-pre marginal means). Error bars indicate standard error of the mean. All group x session interaction effects are designated as significant by stars (* = p≤ .05, ** =.p≤ .01). Sun symbols indicate statistically significant instances where SPD+IA post-training performance was equivalent to or better than the TDC group prior to training. (C) Correlation between MFT power gain (post-pre) and Vanderbilt parent report change (pre-post) plots.