Development and evaluation of a gamified touchscreen app designed to train executive functioning in developmentally vulnerable children living in remote and rural communities.

Paying attention, keeping track of activities, staying focused, and regulating emotions are critical skills required to support mental health, peer relationships, and academic success. These skills are underpinned by multiple cognitive processes, collectively known as executive functions, which develop early in life and become increasingly more robust from preschool onwards. Disruption to these fundamental functions can result in pervasive behavioural symptoms of inattention (e.g. distractibility, poor concentration). In Australia, 1 in 20 school-age children experience a concerning level of these behavioural symptoms, resulting in a clinical disorder, such as attention deficit hyperactivity disorder (ADHD) typically diagnosed at 7 years of age. However, many more children (1 in 8) experience sub-clinical levels of these symptoms, as early as preschool. The presence of inattention symptoms drastically increases a child’s risk of poor mental health, social and academic problems. Overwhelming evidence highlights that early intervention, that targets cognitive processes when they are undergoing critical growth, has the most effective, sustaining impact on a child’s developmental trajectory. Current interventions available for developmentally vulnerable children, such as those experiencing early inattention resulting from poor executive functions, are largely designed exclusively for clinical populations and require access to paediatric clinical services. It is imperative, that targeted cognitive interventions are available to all Australian children early in development to promote optimal and sustained health benefits. A significant proportion (~25%) of Australian children live in remote/regional communities and despite evidence indicating a higher risk of developmental vulnerability, these communities remain grossly underrepresented in clinical research. This exclusion has prevented the development of interventions modelled to the specific needs of children in these communities. This is particularly pertinent to the 65% of Indigenous Australian children living in remote/regional communities, who experience almost double the developmental challenges as their non-Indigenous peers. Indigenous Australian children often face both geographical and cultural barriers when attempting to access early interventions. There is a need to develop new technologies in partnership with remote/regional communities to deliver appropriate early interventions that improve the developing cognitive system in childhood. The current project, aims to meet this need by (1) developing, in partnership with remote/regional communities a digital executive function training program specific to the needs of children living in these communities; and (2) evaluating the acceptability, implementation and efficacy of the executive function training program in remote/regional primary schools.