Brain Plasticity Underlying Acquisition of New Organizational Skills in Children-R61 Phase

Study Overview
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Brief Summary
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Organizational, time management and planning (OTMP) skills deficits are seriously impairing features of developmental disorders, such as Attention Deficit Hyperactive Disorder (ADHD) and autism, which compromise school performance and family relations. The manualized Organizational Skills Training program (OST) was designed to target children's specific OTMP deficits. However, the brain mechanisms of treatment-induced changes remain unknown. The current study combines a training intervention with non-invasive MRI imaging in a pre-/post-design to address this question.

Official Title
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Brain Plasticity Underlying Acquisition of New Organizational Skills in Children

Conditions
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ADHD, Attention Deficit Hyperactivity Disorder, Neurodevelopmental Disorders

Intervention / Treatment
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* Behavioral: OST Intervention for participants with Organizational skill difficulties


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age at entry: age ≥ 8.0 and ≤ 11.9 years corresponding to grades 3-5 Written assent by child and consent by parent or legal guardian IQ: Estimated full scale IQ ≥ 85 and language comprehension scores ≥ 80 is required as in past studies to assure that children are able to comply with specific skills training and to minimize neurobiological heterogeneity Organizational skills deficits defined as elevated (≥ 1SD) pre-treatment COSS Parent Total T-score and at least one COSS Parent Interference item rated as either a 3 or 4 (indicating an above-average level of impairment) Handedness: given the greater prevalence of non-right-handedness in neurodevelopmental disorders, we will track handedness but not exclude left-handed individuals Medication: To minimize variability due to medication effects, we will preferentially recruit currently unmedicated individuals (no psychoactive medications in the previous 3 months). For stimulants, we will require that dosage be stable for >1 month before study entry and parents will be asked to consult their physician regarding discontinuation for 48 hours before evaluation, mock scanning and scanning sessions. Must provide adequate MRI data at baseline Exclusion Criteria: Enrolled in a self-contained special education classroom or served by a 1:1 paraprofessional in their classroom A learning disability on Individualized Education Plan Absence of signed consent by parent or legal guardian Children who dissent regardless of parental permission Full scale IQ < 85 Participants for whom stimulant discontinuation for 48 hours prior to evaluation, mock scan and scanning sessions is deemed medically impermissible Children with a recent (past 6 months) or current history of neuroleptic treatment or current treatment with psychotropic medications other than stimulants Per history (and medical records if needed) medical illness requiring chronic current treatment History of intrathecal chemotherapy or focal cranial irradiation Premature birth (< 32 weeks estimated gestational age or birth weight < 1500g) History of leukomalacia or static encephalopathy, intracerebral hemorrhage beyond grade 2, other specific or focal neurological or metabolic disorder including epilepsy (except for resolved febrile seizures) History of traumatic brain injury Contraindication for MRI scanning (metal implants, pacemakers, metal foreign bodies or pregnancy)

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: OST Intervention<br>12 weekly in-person sessions, each lasting approximately 1 hour, targeting 3 core organizational skills domains-Tracking Assignments, Managing Materials and Time Management | Behavioral: OST Intervention for participants with Organizational skill difficulties<br>* Will undergo two magnetic resonance imaging (MRI) sessions: one within 2 weeks prior to OST treatment and one within 2 weeks of completion of the OST treatment.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in parent Children's Organizational Skills Scales (COSS-P) total T-scores following OST intervention. | Parents (COSS-P) and teachers (COSS-T) will serve as informants (only the child is a study subject) who will provide baseline and outcome ratings. | Day 1 |