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Attention Deficit Disorder With HyperactivitySTARS-ADHDNCT02674633

Software Treatment for Actively Reducing Severity of ADHD

A study testing AKL-T01 and AKL-T09 in people with Attention Deficit Disorder With Hyperactivity, run by Akili Interactive Labs, Inc. at 20 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to evaluate the effects of videogame-like digital therapies on attentional functioning and symptoms in children diagnosed with ADHD. Read more about this study

Who is it for?
Ages 8 to 12 years
What is being tested?
AKL-T01 and AKL-T09
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
348 participants
Where
20 sitesUnited States
Study dates
May 2016to 31 Aug 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 8 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Confirmed ADHD diagnosis, any presentation, at Screening based on the Diagnostic and Statistical Manual of Mental Health-Fifth Edition criteria and established via the MINI-International Neuropsychiatric Interview for Children and Adolescents administered by a trained clinician
  • Screening/Baseline score on the clinician-rated ADHD-RS-IV score >= 28
  • Screening/Baseline score on the TOVA 8 API <= -1.8
  • Not undergoing pharmacological treatment with methylphenidate or amphetamine-based products at time of Screening; or, if undergoing pharmacological treatment, must be willing and appropriate (i.e. not optimally treated in the investigator's judgment) to wash out of current regimen
  • Ability to follow written and verbal instructions (English), as assessed by the PI
  • Estimated Intelligence Quotient score >= 80 as assessed by the Kaufmann Brief Intelligence Test, Second Edition (KBIT-II)
  • Ability to comply with all the testing and requirements.

Who cannot join

  • Current, controlled (requiring a restricted medication) or uncontrolled, comorbid psychiatric diagnosis, based on MINI-KID and subsequent clinical interviewing, with significant symptoms including but not limited to post-traumatic stress disorder, psychosis, bipolar illness, pervasive developmental disorder, severe obsessive compulsive disorder, severe depressive or severe anxiety disorder, conduct disorder, or other symptomatic manifestations that in the opinion of the Investigator that may confound study data/assessments. Participants with clinical history of learning disorders will be allowed to participate, provided the disorder does not impact their ability to participate in the trial based on PI judgment
  • Participants who are currently treated with a non-stimulant medication for ADHD (i.e., atomoxetine, clonidine clonidine, guanfacine)
  • Initiation within the last 4 weeks of behavioral therapy. Participants who have been in behavior therapy consistently for more than 4 weeks may participate provided their routine is unchanged during the course of the study. Participants planning on changing or initiating behavior therapy during the course of the study will be excluded
  • Participant is currently considered a suicide risk in the opinion of the Investigator, has previously made a suicide attempt, or has a prior history of, or is currently demonstrating active suicidal ideation or self-injurious behavior as measured by Columbia Suicide Severity Rating Scale at screening
  • Motor condition (e.g., physical deformity of the hands/arms; prostheses) that prevents game playing as reported by the parent or observed by the investigator
  • Recent history (within the past 6 months) of suspected substance abuse or dependence
Show all 14Show fewer
  • History of seizures (exclusive of febrile seizures), or significant motor or vocal tics, including but not limited to Tourette's Disorder
  • Has participated in a clinical trial within 90 days prior to screening
  • Diagnosis of or parent-reported color blindness (Confirmed in-clinic via ICBT)
  • Uncorrected visual acuity (Confirmed in-clinic via ability of subject to play the intervention)
  • Regular use of psychoactive drugs (other than stimulant) that in the opinion of the Investigator may confound study data/assessments
  • Any other medical condition that in the opinion of the investigator may confound study data/assessments
  • Has a sibling also enrolled/currently participating in the same study
  • Has previously participated in a study of Akili's EVO videogame-like digital therapy

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

United States20 sites
  • Kennedy Krieger Institute

    Baltimore, Maryland, 21205

  • Northwest Clinical Research Center

    Bellevue, Washington, 98007

  • Meridien Research

    Bradenton, Florida, 34208

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • FutureSearch Trials

    Dallas, Texas, 75231

  • Harmonex Neuroscience Research

    Dothan, Alabama, 36303

  • Duke Child and Family Study Center

    Durham, North Carolina, 27705

  • Bayou City Research, Ltd

    Houston, Texas, 77007

  • Center for Psychiatry and Behavioral Medicine

    Las Vegas, Nevada, 89128

  • Capstone Clinical Research

    Libertyville, Illinois, 60048

  • Florida Clinical Research Center

    Maitland, Florida, 32751

  • South Shore Psychiatric Services

    Marshfield, Massachusetts, 02050

  • Avida, Inc.

    Newport Beach, California, 92660

  • IPS Research Company

    Oklahoma City, Oklahoma, 73103

  • The Neuropsychiatric Clinic at Carolina Partners

    Raleigh, North Carolina, 27606

  • University of California Davis MIND Institute

    Sacramento, California, 95817

  • Midwest Research Group

    Saint Charles, Missouri, 63304

  • University of California, San Francisco

    San Francisco, California, 94143

  • Melmed Center

    Scottsdale, Arizona, 85254

  • Seattle Children's

    Seattle, Washington, 98121

Other trials in United States

About this study

Official title: A Randomized, Controlled, Parallel-group, Intervention Study to Assess At-home, Game-based Digital Therapy for Treating Pediatric Participants Ages 8 to 12 Years Old With Attention Deficit Hyperactivity Disorder (ADHD)

The purpose of this study is to evaluate the effects of videogame-like digital therapies on attentional functioning and symptoms in children diagnosed with ADHD.

Read the detailed description

The study will be a randomized, parallel group, controlled trial of two videogame-like (iPad-based) digital therapies. The study will consist of 3 primary phases: Screening, Washout/Baseline, and Treatment. During the Screening Phase (Day -28 to Day -7), participants will undergo screening to evaluate eligibility for the study. Screening may take place up to 28 days before the Baseline Visit (Day 0). For those children currently on medication for ADHD the Washout period will begin 7 days prior to Baseline where treatment will be discontinued. On Day 0, the Baseline visit will occur wherein additional eligibility criteria will be established. The Treatment Phase (Day 1 to Day 27) will involve using the digital therapy at home for each participant followed by an In-Clinic assessment on Day 28 to assess key outcomes. Compliance with treatment/use requirements will be monitored remotely during this phase.

Being tested
AKL-T01, AKL-T09
Keywords
ADHD
Medical subject headings
Attention Deficit Disorder with Hyperactivity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AKL-T01Device

    Also called EVO Multi

    Videogame-like digital therapy

  • AKL-T09Device

    Also called EVO Words

    Videogame-like digital therapy

Study groups in NCT02674633
Study groupRoleWhat they receive
AKL-T01 (EVO Multi)Active comparatorAKL-T01, or EVO Multi, is a digital intervention that requires the subject to navigate a character through a game-like space, while collecting objects, in a fixed period of time.
Receives: Device: AKL-T01
AKL-T09 (EVO Words)Active comparatorAKL-T09, or EVO Words, is a digital intervention that requires the subject to spell as many words as possible, by connecting letters in a game-like grid, in a fixed period of time.
Receives: Device: AKL-T09

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Test of Variables of Attention-Attention Performance Index (Change From Baseline to Posttreatment)

    TOVA API is a comparison of the subject's scores based on selected measures that persons with an independent diagnosis of ADHD frequently demonstrated. The API is calculated from variability, response time, and d' (D Prime) using the following formula:

    API = Response Time Z score (Half 1) + d' Z score (Half 2) + Variability Z score (Total) + 1.80 where Response Time is the average time it takes to respond correctly to a target, d' score is a response discriminability score reflecting the ratio of hits to "false alarms", and Variability is a measure of consistency of speed of responding based on the standard deviation of the mean correct response times. API tells how similar the score is to the ADHD profile. A score of less than 0 indicates that the subject had similar performance to a normative ADHD population. A lower score indicates a more severe ADHD profile.

    The calculation for difference in TOVA API was API at Day 28 minus API at Day 0 of this study.

    Measured: Day 0 to Day 28

Secondary outcomes (7)
  1. ADHD-RS Total (Change From Baseline to Posttreatment)

    The ADHD-RS-IV is an 18-item, clinician-administered questionnaire for which a parent respondent rates the frequency of occurrence of ADHD symptoms and behaviors as defined by criteria outlined for ADHD in the DSM-IV. Each item is scored on a 4-point scale ranging from 0 (rarely or never) to 3 (very often) with total scores ranging from 0-54. A higher score indicates more severe ADHD symptoms and behaviors. A negative change in total score indicates improvement from Day 0 to Day 28.

    Measured: Day 0 to Day 28

  2. ADHD-RS Inattentive Subscale (Change From Baseline to Posttreatment)

    The ADHD-RS-IV is an 18-item, clinician-administered questionnaire for which a parent respondent rates the frequency of occurrence of ADHD symptoms and behaviors as defined by criteria outlined for ADHD in the DSM-IV. Each item is scored on a 4-point scale ranging from 0 (rarely or never) to 3 (very often) with total scores ranging from 0-54. A higher score indicates more severe ADHD symptoms and behaviors.

    The 18 items are grouped into 2 subscales: hyperactivity/impulsivity (even numbered items 2-18) and inattentiveness (odd numbered items 1-17). Each subscale produces a sub-scale score ranging from 0-27. A higher subscale score indicates more severe ADHD symptoms and behaviors.

    A negative change indicated improvement on the subscale from Day 0 to Day 28.

    Measured: Day 0 to Day 28

  3. ADHD-RS Hyperactivity Subscale (Change From Baseline to Posttreatment)

    The ADHD-RS-IV is an 18-item, clinician-administered questionnaire for which a parent respondent rates the frequency of occurrence of ADHD symptoms and behaviors as defined by criteria outlined for ADHD in the DSM-IV. Each item is scored on a 4-point scale ranging from 0 (rarely or never) to 3 (very often) with total scores ranging from 0-54. A higher score indicates more severe ADHD symptoms and behaviors.

    The 18 items are grouped into 2 subscales: hyperactivity/impulsivity (even numbered items 2-18) and inattentiveness (odd numbered items 1-17). Each subscale produces a sub-scale score ranging from 0-27. A higher subscale score indicates more severe ADHD symptoms and behaviors.

    A negative change indicated improvement on the subscale from Day 0 to Day 28.

    Measured: Study Day 0 to Study Day 28

  4. BRIEF Working Memory Percentile (Change From Baseline to Posttreatment)

    The Behavior Rating Inventory of Executive Function (BRIEF) is a parent-rated form that assesses everyday behavior associated with specific domains of the executive functions of their child. The BRIEF working memory metacognition subscale measures the participants ability to hold information when completing a task in a sequential manner.

    A negative change in percentile indicated an improvement on the subscale.

    Measured: Day 0 to Day 28

  5. BRIEF Inhibit Percentile (Change From Baseline to Posttreatment)

    The Behavior Rating Inventory of Executive Function (BRIEF) is a parent-rated form that assesses everyday behavior associated with specific domains of the executive functions of their child. The BRIEF Inhibit subscale measures the participant's ability to control impulses and to stop engaging in a behavior.

    A negative change in percentile indicated an improvement on the subscale.

    Measured: Day 0 to Day 28

  6. Impairment Rating Scale, Overall Impairment (Change From Baseline to Posttreatment)

    The Impairment Rating Scale (IRS) is a parent-rated scale that assesses individualized areas of impairment for a child participant and asks parents to make a rating of how significantly these problems impact functioning across a range of domains (social, family, school, self-esteem). Parents describe the primary areas of difficulty for each child and then provide a rating (via a Visual Analog Scale) of how much the difficulties affect the different areas of functioning ranging from (1) "no problem; definitely does not need treatment or special services" to (7) "extreme problem; definitely needs treatment or special services."

    The total IRS is 8 items, the 8th rating overall impairment. A negative change indicated a decrease in overall impairment.

    Measured: Day 0 to Day 28

  7. CGI-I (at Posttreatment)

    The Clinical Global Impression Scale - Improvement (CGI-I) is a clinician's comparison of the participant's overall clinical condition at follow up to the overall clinical condition at baseline. The CGI-S is a 7-point scale where 1 = Very much improved, 2=Much improved, 3=Minimally improved, 4=No change, 5=Minimally worse, 6=Much worse, and 7=Very much worse.

    A score of 1, 2, or 3 would indicate overall improvement of ADHD severity.

    Measured: Day 28

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Feb 2016 (estimated)
  2. Study startMay 2016
  3. Primary completion31 Jul 2017
  4. Study completion31 Aug 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Minimum number of subjects = 300, Anticipated number of subjects = 330, Maximum number of subjects = 1,000
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
348 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02674633
Sponsor's protocol ID
Akili-001R
Acronym
STARS-ADHD
Status last verified
Aug 2020
First submitted
2 Feb 2016
Last updated
14 Aug 2020
Data monitoring committee
No
Individual data sharing
Undecided

Publications

  • Stamatis CA, Heusser AC, Simon TJ, Ala'ilima T, Kollins SH. Real-time cognitive performance metrics derived from a digital therapeutic for inattention predict ADHD-related clinical outcomes: Replication across three independent trials of AKL-T01. Transl Psychiatry. 2024 Aug 11;14(1):328. doi: 10.1038/s41398-024-03045-0.

    PubMed 39128918
  • Kollins SH, DeLoss DJ, Canadas E, Lutz J, Findling RL, Keefe RSE, Epstein JN, Cutler AJ, Faraone SV. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial. Lancet Digit Health. 2020 Apr;2(4):e168-e178. doi: 10.1016/S2589-7500(20)30017-0. Epub 2020 Feb 24.

    PubMed 33334505

Questions about this trial

What is this clinical trial studying?

A study testing AKL-T01 and AKL-T09 in people with Attention Deficit Disorder With Hyperactivity, run by Akili Interactive Labs, Inc. at 20 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 Jul 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Test of Variables of Attention-Attention Performance Index (Change From Baseline to Posttreatment) (time frame: Day 0 to Day 28). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02674633, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Aug 2020.

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STARS-ADHD Clinical Trial NCT02674633 | AzTrials