Training attention control among very preterm infants: results from a feasibility study

Children born very preterm (28 to <32 weeks of gestation) are at increased risk of cognitive delays and lower educational attainments. These developmental risks have been linked to anomalies in attention and information processing abilities displayed by very preterm infants during their first years of life. Early interventions that target attention skills may help these infants establish the necessary building blocks for later cognitive attainments. We tested the delivery of an early intervention that targeted infants’ attention control, i.e. the ability to voluntarily select what to attend and what to ignore, using a computerised cognitive training programme. In this programme we showed interactive games whereby cartoon characters on the screen responded to what infants were watching: infants received “reward” animations (e.g. a funny display) if they met increasingly challenging attention demands during the games (e.g. fixing gaze to some characters for longer periods). We recruited a small sample of very preterm infants (N = 10) aged approximately 12 months or over (corrected aged) randomly allocated to receiving the computerised training or control procedures during three consecutive weekly visits. Infants completed a battery of computerised attention tasks (e.g. visual memory), naturalistic focused attention, and social communication tasks before and after completing the study. We analysed the results using Bayesian regression analysis in order to estimate treatment effects. Compared to controls, trained infants improved their visual memory and abilities to attend to less salient stimuli presentations. We also reported moderate improvements in focused attention during naturalistic tasks, and in directing other people’s attention to shared objects. The results suggest that the training of attention control in very preterm infants may improve attention skills among this at-risk population, at least in the short term. We will discuss future directions in replicating and extending these results and challenges in the implementation of similar interventions.