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Attention Training in Autism as a Potential Approach to Improving Academic Performance: A School-Based Pilot Study

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Abstract

This study assessed the effectiveness of an attention intervention program (Computerized Progressive Attentional Training; CPAT) in improving academic performance of children with ASD. Fifteen 6–10 year olds with ASD attending a mainstream and a special school were assigned to an experimental (CPAT; n = 8) and active control (computer games; n = 7) group. Children were assessed pre- and post-intervention on measures of behavioural symptoms, cognitive skills and academic performance. The intervention was conducted in school twice a week for 8 weeks. Children in the CPAT group showed cognitive and academic improvements over and above the active control group, while children in both groups showed improvements in behaviour. Results suggest that attention training is a feasible approach to improving academic performance in this population.

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Acknowledgments

We thank the research assistants Anjli Pattni, Marianna Ruiz and Polly Brayfield for their hard work assisting the conduction of the intervention and assessments. Mayra Muller Spaniol was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES; BEX: 2903/13-0).

Funding

This work was conducted during a scholarship supported by the International Cooperation Program CAPES at the University of Birmingham. Financed by CAPES—Brazilian Federal Agency for Support and Evaluation of Graduate Education within the Ministry of Education of Brazil, BEX: 2903/13-0.

Author information

Authors and Affiliations

  1. Department of Developmental Disorders, Universidade Presbiteriana Mackenzie, São Paulo, Brazil

    Mayra Muller Spaniol

  2. School of Education and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel

    Lilach Shalev

  3. School of Education, University of Birmingham, Birmingham, UK

    Lila Kossyvaki

  4. School of Psychology, University of Birmingham, Birmingham, UK

    Carmel Mevorach

Authors
  1. Mayra Muller Spaniol
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  2. Lilach Shalev
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  3. Lila Kossyvaki
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  4. Carmel Mevorach
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Contributions

MMS was the principal researcher, participated in the study design, coordination, performed the measurements, performed the statistical analysis, interpretation of the data and drafted the manuscript; LS conceived of the study, participated in the design and interpretation of the data; LK participated in the design and coordination of the study; CM conceived of the study, participated in the design of the study, interpretation of the data and helped to draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mayra Muller Spaniol.

Ethics declarations

Conflict of interest

All authors declare that there is no conflict of interest.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Appendices

Appendix 1

Interview with Teachers

Preamble

Talk about:

  • Project—aimed at improving basic attentional processes involved in school activities

  • Academic assessment (content they are seeing in class—maths, reading, writing and copying)

  • CARS

  • Preferences for break activities

Pre interview

  • What do you think are their difficulties regarding academic, social, attentional and personal domains?

  • What are your expectations from the training?

Post interview

  • How are they doing academically, socially, personally now?

  • How is their attention in the classroom?

  • Any other comments about the project?

Appendix 2

Quotes from the interviews:

CPAT

“CH11 and CH14 improved in maths, one level up since the beginning of the project” (ST). “CH11 is better at doing tasks, it is easier to get him to work on tasks, and attention has improved” (TA1). “He pays attention to details a lot more” (TA2). “CH14. shows improvement in work boxes, she used to flip, but now seems more attentive and more interested in doing the tasks.” (TA1).

“CH16. still shows some disruptive behaviours, not as much after the project. Making progress in maths, better concentration but still needs some prompting sometimes. Can do more now on his own” (ST). “CH16 has improved; it’s easier to get him to focus in activities” (TA1).

“CH12 has improved concentration and attention skills, he used to get distracted. Maths improved, numbers, English improved, he is progressing really well” (ST). “He is aware of his own behaviour, and is showing better listening skills now” (TA2).

“CH3 is more confident and independent… He does things by himself now. CH3 is showing progress in numeracy, improved focus and concentration but still has good and bad days” (MT1).

“CH1 shows greater academic achievement; more likely to go and talk to people; more focus and attention to the task. More independent and confident, can do tasks on her own and asks questions, better communication and social interactions” (MT2).

“CH5 is concentrating in tasks a bit more, for longer. CH5 is making academic progress; he can concentrate in tasks in class for longer, before it used to be 2 min” (MT3).

“CH6 made some academic progress, just not as much as one could possibly hope for. He’s not quite there yet, so inconsistent, some days are better than others. Lower levels of learning, numbers need to keep going back to adding, taking away, and number recognition. Talks to himself more. Has many social interactions, but always on his terms”. (MT1).

Control

“CH8 is more participative in class, still shows difficulties in doing tasks independently and needs prompting. He is progressing academically in maths but not so much in literacy” (MT3).

“CH4 understands pure maths but has difficulties with shapes and meaning of words and mathematical problems. He is more confident and independent. Shows more stereotyped behaviours, has problems concentrating and still needs prompting to do tasks” (MT1).

“CH9 still needs prompting to pay attention…Same academic performance” (ST). “Attention slips a bit” (TA1). “He gained a lot of confidence, good computer skills, important for life: learning to interact with the computer” (TA2).

“CH10 and CH15 have always been good” (TA1). “CH10 shows good behaviour, progressing in maths, English, good concentration” (ST). “CH15’s behaviour got worse, he is expressing more, communicating more (started to hit). Can concentrate in maths, English not so much, depends on the task needs prompting. Keeps good academic progress not major jump” (ST).

“CH13 improved behaviour in activities, completely different during activities” (TA1). “He can sit and work through tasks but not major progress academically” (ST).

Across Groups

Interestingly, there was a direct comparison between two boys, one from the CPAT and one from the control group, who were from the same classroom, according to MT3: “CH5 is concentrating in tasks a bit more, for longer….CH5 (CPAT) is more focused than CH8 (control). CH8 gets more distracted, still needs prompting and has difficulties in doing tasks independently. CH5 is making academic progress, he can concentrate in tasks in class for longer, before it used to be 2 min”. In particular, TA2 mentioned that all children were showing “smiles on their faces: children have been very enthusiastic to participate” (TA2).

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Spaniol, M.M., Shalev, L., Kossyvaki, L. et al. Attention Training in Autism as a Potential Approach to Improving Academic Performance: A School-Based Pilot Study. J Autism Dev Disord 48, 592–610 (2018). https://doi.org/10.1007/s10803-017-3371-2

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  • DOI: https://doi.org/10.1007/s10803-017-3371-2

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