Mindful Attention Training for Pediatric Cancer Survivors
Recruiting in Palo Alto (17 mi)
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of California, San Francisco
Disqualifiers: Motor difficulties, Perceptual difficulties, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This pilot study will evaluate the cognitive and behavioral outcomes of using a novel, adaptive attention training in pediatric cancer survivors.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, if you are on cancer-related treatments, it will be discussed with the study team to see if it affects your participation.
What data supports the effectiveness of the treatment Mindful Attention Training for Pediatric Cancer Survivors?
Research shows that attention training can help improve attention in children who have survived cancer, with studies indicating improvements in attention measures. A cognitive remediation program for cancer survivors showed significant improvement in attention, suggesting that similar attention-focused treatments could be beneficial.
12345Is Mindful Attention Training safe for children, including those who have survived cancer?
The studies reviewed suggest that attention training programs, including computerized cognitive training, have been used safely in children, including those who have survived cancer. These programs have shown good feasibility and acceptability, with no significant safety concerns reported.
45678How is Novel Mindful Attention Training different from other treatments for pediatric cancer survivors?
Novel Mindful Attention Training is unique because it focuses on improving attention and cognitive functions through mindfulness techniques, which is different from traditional treatments that may not specifically target attention issues. This approach is particularly relevant for pediatric cancer survivors who often experience attention problems due to their illness or treatment.
34789Eligibility Criteria
This trial is for children aged 7-17 who have survived pediatric cancer, can follow the study's procedures, and have a guardian to consent. They should speak English fluently, not be on certain cancer treatments that affect participation, and must have had radiation therapy to the brain or neck.Inclusion Criteria
My vision and hearing are normal, or corrected to normal.
I am between 7 and 17 years old.
I, and if applicable, my legal guardian, can understand and are willing to sign the informed consent document.
+4 more
Exclusion Criteria
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)
Contraindication to any study-related procedure or assessment
You have difficulty using a computer or tablet due to problems with moving or understanding things.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants complete adaptive attention training ('Engage') for 6-8 weeks, with randomized cohorts completing either 15 hours or 1 hour of training.
6-8 weeks
Follow-up
Participants are monitored for cognitive and behavioral outcomes after completing the training.
4 weeks
No Contact Group Assessment
Participants in the no-contact group complete baseline and end-of-study assessments to evaluate assessment feasibility and reliability.
6-8 weeks
Participant Groups
The study tests an adaptive attention training program against standard questionnaires to see if it improves thinking skills and behavior in kids who've beaten cancer. It's a pilot study which means it's preliminary research before larger studies.
3Treatment groups
Experimental Treatment
Active Control
Group I: No Contact Group (Not Randomized)Experimental Treatment1 Intervention
An additional thirty participants will be enrolled separately (not randomized) into the no-contact group. Participants in the no-contact group will not complete any study activities for 6-8 weeks after completing the baseline assessments. After this period, participants will be prompted to log into Nexus to complete end of study assessments (same set of assessments administered/completed at baseline).
Group II: Adaptive Attention TrainingExperimental Treatment2 Interventions
Participants will complete approximately 15 hours of an at-home training on a novel adaptive attention training program ('Engage'), which will consist of completing thirty, 30-minute sessions over a total of 6-8 weeks.
Group III: Low-dose Adaptive Attention TrainingActive Control2 Interventions
Participants will complete approximately 1 hour of at-home training on 'Engage' which consists of two, 30-minute sessions at the beginning and middle of a 6-8 week period.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Univeristy of California, San FranciscoSan Francisco, CA
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Who Is Running the Clinical Trial?
University of California, San FranciscoLead Sponsor
References
Performance-based and parent ratings of attention in children treated for a brain tumor: The significance of radiation therapy and tumor location on outcome. [2019]Children are at increased risk for cognitive difficulties following the diagnosis and treatment of a brain tumor. Radiation therapy (RT) and tumor location are commonly-cited predictors of neurocognitive functioning. Disruptions to foundational neurocognitive processes such as attention, working memory, and processing speed underlie declines on measures of general intellectual functioning. While several studies have examined visual sustained attention in pediatric brain tumor patients, auditory sustained attention has yet to be examined. This study employs a longitudinal design to examine performance-based and parent ratings of attention in children undergoing surgical resection of a brain tumor (n = 29) and treated with (n = 11) or without (n = 18) RT at 6.79 months post-surgery (baseline) and then again at 30.56 months post-surgery (follow-up). The measures include an auditory continuous performance test (CPT) and parent ratings of attention and hyperactivity on a behavior rating scale. Ultimately, children treated with and without RT performed similarly on performance-based and parent ratings of attention. However, the performance on the auditory CPT differed according to tumor location, with children with infratentorial tumors committing more inattention and inhibitory control errors compared to children with supratentorial tumors. Parent ratings did not differ according to tumor location, and parent ratings and auditory sustained attention performance are not significantly correlated. The findings are interpreted in the context of neurocognitive and brain development.
Sleep and neurobehavioral functioning in survivors of pediatric cancer. [2021]Sleep problems are a common late effect in survivors of pediatric cancer. Growing literature suggests deficits in sleep functioning may be related to more impairing neurobehavioral outcomes. The purpose of the present study was to evaluate the prevalence of parent reported sleep concerns in survivors of pediatric cancer, as well as evaluate the relationship between sleep and neurobehavioral functioning utilizing both parent and teacher input.
Impact of attention on social functioning in pediatric medulloblastoma survivors. [2018]Parent-reported attention problems have been associated with social functioning in a broad sample of pediatric cancer survivors.
Remediation of attention deficits in children: a focus on childhood cancer, traumatic brain injury and attention deficit disorder. [2007]The purpose of this review is to examine the status of attention training in children. This body of literature is very small so the review examines available efficacy studies in three paediatric groups: children who have survived cancer affecting the central nervous system (CNS) or whose treatment has impacted the CNS, children with traumatic brain injury (TBI) and children with attention deficit disorder (ADD). Seven studies/case reports are reviewed. The results are encouraging, with six of seven describing some improvement on attention measures. An original case study is presented using Pay Attention! materials with a 6 year old survivor of acute lymphoblastic leukaemia (ALL). This represents only the third report of the use of attention training materials with a survivor of childhood cancer and the first case report of the use of these materials with a very young child (6 years of age).
Attentional processes and their remediation in children treated for cancer: a literature review and the development of a therapeutic approach. [2022]It is now generally accepted that central nervous system treatments for childhood cancer can result in significant cognitive impairment, most commonly in the areas of attention/concentration. We review the literature on attentional and neurocognitive deficits in this population, and also efforts to remediate attentional deficits in other brain injured populations. It was our goal to develop an innovative, psychologically based outpatient rehabilitation program that would improve dysfunctional attentional processes and associated neuropsychological deficits. The characteristics of this program and a pilot study of its effectiveness are described. Participants were 31 off-therapy cancer survivors with documented attention deficits. Twenty-one completed the cognitive remediation program (CRP) and 10 served as comparisons. All participants completed a test of vigilance attention, 2 tests with an attentional component, and an arithmetic academic achievement measure. When the scores of the 2 groups were compared, the CRP group exhibited statistically significant improvement on all attentional measures. In contrast, the comparison group did not manifest any significant changes. Neither group demonstrated statistically significant changes on the arithmetic achievement test. We believe that the CRP has potential for improving attention/concentration, but generalization to academic achievement remains unproven. Phase 3 clinical trials and the documentation of long-term treatment gains are needed. Furthermore, it will be necessary to demonstrate the ecological validity of the CRP. With these caveats, this therapeutic approach may be helpful in other populations of cognitively impaired children and young adults, such as patients who have suffered traumatic brain injury.
Cognitive training programs for childhood cancer patients and survivors: A critical review and future directions. [2018]A robust literature has developed documenting neurocognitive late effects in survivors of leukemia and central nervous system (CNS) tumors, the most frequent cancer diagnoses of childhood. Patterns of late effects include deficits in attention and concentration, working memory, processing speed, and executive function, as well as other domains. As childhood cancer survivors are living longer, ameliorating deficits both in broad and specific neurocognitive domains has been increasingly recognized as an endeavor of paramount importance. Interventions to improve cognitive functioning were first applied to the field of pediatric oncology in the 1990s, based on strategies used effectively with adults who had sustained a traumatic brain injury (TBI). Compilation and modification of these techniques has led to the development of structured cognitive training programs, with the effectiveness and feasibility of such interventions currently an active area of research. Consequently, the purpose of this critical review is to: (1) review cognitive training programs intended to remediate or prevent neurocognitive deficits in pediatric cancer patients and survivors, (2) critically analyze training program strengths and weaknesses to inform practice, and (3) provide recommendations for future directions of clinical care and research.
[Formula: see text]The contribution of sluggish cognitive tempo to processing speed in survivors of pediatric brain tumors. [2021]Sluggish Cognitive Tempo (SCT) describes a pattern of under-activity, poor initiation, and slowness. It was first reported within the Attention Deficit Hyperactivity Disorder (ADHD) literature and found to be positively associated with the inattentive symptoms of ADHD and negatively or not significantly associated with the hyperactivity/impulsivity symptoms of ADHD. SCT has since been considered applicable to the pediatric oncology population given the emergence of inattentive, sluggish symptoms secondary to cancer treatment. The present study examined the unique contribution of SCT to various processing speed skills in a clinical sample of pediatric brain tumor (BT) survivors in order to determine the degree to which SCT explained timed "cognitive" processing components. Measures included speeded naming, graphomotor speed, and speeded inhibition. Hierarchical linear regression analyses were used to predict performance-based measures of processing speed. After controlling for verbal ability and inattention, SCT, particularly Daydreamy SCT (β = -0.698, p = 0.023), explained 28% of variance in speeded inhibition. SCT did not add significantly to the prediction of speeded naming or graphomotor speed. Findings suggest that the "daydreamy" aspect of SCT, rather than "sluggishness" per se, may be related to more complex, cognitively-demanding tasks with greater executive functioning burdens in BT survivors. Implications for intervention for oncology survivors as well as future research directions are discussed.
Computerized cognitive training in survivors of childhood cancer: a pilot study. [2023]The objective of the current study was to pilot a computerized cognitive training program, Captain's Log, in a small sample of survivors of childhood cancer. A total of 9 survivors of acute lymphoblastic leukemia and brain tumors with attention and working memory deficits were enrolled in a home-based 12-week cognitive training program. Survivors returned for follow-up assessments postintervention and 3 months later. The intervention was associated with good feasibility and acceptability. Participants exhibited significant increases in working memory and decreases in parent-rated attention problems following the intervention. Findings indicate that home-based, computerized cognitive intervention is a promising intervention for survivors with cognitive late effects; however, further study is warranted with a larger sample.
Intellectual functioning and multi-dimensional attentional processes in long-term survivors of a central nervous system related pediatric malignancy. [2013]Central nervous system (CNS) malignancies and/or their treatment in pediatric cancer survivors are known to be associated with deficits in neuropsychological functions. We report findings from a nation-wide study of childhood cancer survivors to investigate intelligence and attention/concentration from a multi-dimensional perspective in a diverse sample from this population.