ABC Brain Games Self-Regulation Intervention

Primary outcomes

1. Change in Working Memory

   Time frame: 6 weeks

   Working memory is assessed using a standardized digit span task from the Wechsler Intelligence Scale for Children-WISC-IV, which requires participants to recite digits they have just heard in progressively longer sequences. The longest correct span of digits the participants repeats is the index of working memory.

2. Change in Inhibitory Control

   Time frame: 6 weeks

   Inhibitory control is measured using a go/no-go task. In this task, children are taught to play a computer-based "Zoo" game wherein their goal is to help the zookeeper find animals that have escaped and are loose in the zoo. Children are instructed to press a key to respond as fast as possible when they see the "go" stimulus (i.e., an orangutan who is "helping" the zookeeper retrieve the escaped animals, presented for 300 ms) but not when they see the no-go stimulus (i.e., any other animal that has "escaped"). The task thus requires children to demonstrate the capacity to inhibit the response to "go" when they see the "helper" animal, and indexes inhibitory control. Scores on this task are scored based on accuracy and reaction time.

3. Change in Behavior Rating Inventory of Executive Functioning (BRIEF)

   Time frame: 6 weeks

   Parents complete the 86-item Behavior Rating Inventory of Executive Function (BRIEF). The BRIEF yields two broad subscales of Behavioral Regulation and Metacognition that reflect the child's planning and organizing capabilities, attention shifting, working memory, and emotional control.

4. Change in emotional and behavioral displays indicating frustration

   Time frame: 6 weeks

   Child emotional and behavioral displays indicating frustration in response to a task designed to be frustrating (a lockbox with a wrong key) are videotaped and coded for latency to and intensity of child negative affect (e.g., frown, cry) or behavioral indicators of frustration (e.g., loud sigh, set keys down roughly).

5. Change in SIDES Affect dysregulation scale

   Time frame: 6 weeks

   Individual interview using SIDES Affect dysregulation scale to assess the child's ability to control feelings and how much strong feelings get in the way of doing things (e.g., "small problems got me very upset").

6. Change in Children's Emotion Management Scales

   Time frame: 6 weeks

   Children report on their tendency to engage in reappraisal and suppression emotion regulation strategies using the Children's Emotion Management Scales (e.g., "when I am feeling mad, I can stop myself from losing my temper"). Children report on the use of such strategies for feelings of anger, sadness, and worry and subscales are created to generate effective emotion management strategy scores for each emotion, and overall.

7. Change in NIH Toolbox scale

   Time frame: 6 weeks

   Parents report on child perceived stress responses, or how well the parent views the child's capacity to cope with stress, using the parent-report NIH Toolbox scale to assess perceived stress.

8. Change in Positive and Negative Affect Schedule for children

   Time frame: 6 weeks

   Parents report on child positive and negative mood using the Positive and Negative Affect Schedule for children, which presents parents with different positively- and negatively-valenced words and asks them to indicate which words best describe the way they perceive the child to feel, in general (e.g., upset, scared vs. interested, excited). Responses are summed to generate positive and negative affect scores.

9. Change in episodic future thinking

   Time frame: 6 weeks

   The interviewer asks children to think of three different upcoming future events that could happen over the next few days, next week, and the next few months, and to describe each event. The interview is audiotaped and later coded using an adaptation of prior coding systems.Indicators of episodic future thinking include use of rich, descriptive detail, vivid imagery, future-oriented language (e.g., "we will…"), and coherent narratives. Coding of the interviews is thus based on the level of detailed description of specific events; child use of future-oriented language; mental state language; and narrative coherence, and scores for richness of episodic future thinking language are generated.

10. Change in NIH Self-Efficacy

    Time frame: 6 weeks

    The NIH Self-Efficacy questionnaire assesses a participant's belief in his/her capacity to manage and have control over meaningful events (e.g., "I can manage to solve difficult problems if I try hard enough").

11. Change in Future Time Perspective subscale from the Zimbardo Time Perspective Questionnaire

    Time frame: 6 weeks

    Children indicate how much different items reflect their views ("I can manage to solve difficult problems if I try hard enough"; "I finish projects on time by working on them a little bit every day") and scores are generated to reflect the level of future-oriented time perspective .

12. Change in Ratio Reinforcing Computer Task

    Time frame: 6 weeks

    Relative reinforcing value (RRV) for food is determined by measuring child responses on a Ratio Reinforcing Computer Task to obtain palatable food. The child is shown how to play the game on a computer and told to play the game to win candy prizes (chocolate, gummy candy, etc.). Each computer screen displays three boxes containing different shapes, and each time a key is pressed the shapes rotate and change. When all shapes match, the child receives a point and for every five points, is given a ticket to use to redeem for candy at the end of the visit. The schedule of reinforcement begins at 10 presses to earn one point and doubles each time a ticket is earned (Progressive Ratio (PR) 20, PR 40, PR 80, PR 160, PR 320, PR 640, PR 1280, PR 2560, PR 5120, PR 10240). Food reinforcement is identified by the highest reinforcement schedule completed by the child to earn candy, with higher values indicating greater motivation to work for food, indexing food reward.

13. Change in implicit food bias

    Time frame: 6 weeks

    This task assesses implicit associations between images of chocolate and "stopping" versus "going". Children are first shown how to press buttons based on whether they see a "stop" (e.g., hand signaling stop) or a "go" signal (e.g., walk sign; 16 trials). In block 2 (48 trials) children sort the "stop" or "go" signals by pressing one of the buttons when one of the signals is paired with an image of chocolate (e.g., "go+chocolate") and the other button for the other (unpaired) signal ("stop"). In block 3 (48 trials), the pattern is reversed and children sort the "stop" or "go" signals based on the alternate signal-chocolate pairing (e.g., "stop+chocolate" vs. "go"). Scores are calculated using the D600 scoring protocol such that higher values on the task indicate a stronger implicit association between chocolate and "go" compared to chocolate and "stop" signals, suggesting an implicit bias toward chocolate.

14. Change in Power of Food Scale

    Time frame: 6 weeks

    Children complete this 15-item scale that assesses individual differences in sensitivity to food cues in the environment (e.g.. "I think about food even when I'm not truly hungry ") and the ability of these cues to increase desire for food (e.g., "If I see or smell a food I like, I get a powerful urge to have some ").