The Effect of Music Intervention on Attention in Children

Several studies have reported that music interventions may have a positive impact on attention. It has been proposed that music itself contains ... ThisarticleispartoftheResearchTopic TheClinicalNeuroscienceofMusic:EvidenceBasedApproachesandNeurologicMusicTherapy Viewall 15 Articles Articles Michaelh.Thaut UniversityofToronto,Canada MireilleBesson UMR7291LaboratoiredeNeurosciencesCognitives(LNC),France LauraD.Branco PontificalCatholicUniversityofRioGrandedoSul,Brazil Theeditorandreviewers'affiliationsarethelatestprovidedontheirLoopresearchprofilesandmaynotreflecttheirsituationatthetimeofreview. Abstract Introduction MaterialsandMethods Results Discussion Conclusion DataAvailabilityStatement EthicsStatement AuthorContributions Funding ConflictofInterest Acknowledgments SupplementaryMaterial References SuggestaResearchTopic> DownloadArticle DownloadPDF ReadCube EPUB XML(NLM) Supplementary Material Exportcitation EndNote ReferenceManager SimpleTEXTfile BibTex totalviews ViewArticleImpact SuggestaResearchTopic> SHAREON OpenSupplementalData ORIGINALRESEARCHarticle Front.Neurosci.,24July2020 |https://doi.org/10.3389/fnins.2020.00757 TheEffectofMusicInterventiononAttentioninChildren:ExperimentalEvidence YukaKasuya-Ueba1*,ShuoZhao2*andMotomiToichi1,3 1DepartmentofHumanHealthScience,GraduateSchoolofMedicine,KyotoUniversity,Kyoto,Japan 2InstituteofPsychology,ShenzhenKeyLaboratoryofAffectiveandSocialNeuroscience,ShenzhenUniversity,Shenzhen,China 3TheOrganizationforPromotingNeurodevelopmentalDisorderResearch,Kyoto,Japan Althoughmusichasbeenutilizedasatherapeutictoolforchildrenwithcognitiveimpairments,howitimproveschildren’scognitivefunctionremainspoorlyunderstood.Asafirststeptowardunderstandingmusic’seffectivenessandasameansofassessingcognitivefunctionimprovement,wefocusedonattention,whichplaysanimportantroleincognitivedevelopment,andexaminedtheeffectofamusicinterventiononchildren’sattention.Thirty-fivechildren,aged6to9years,participatedinthisstudy,withdatafrom29ofthechildrenbeingincludedintheanalysis.Asingle30-minuteinteractivemusicinterventionwascomparedwithasingle30-minuteinteractivevideogameinterventionaccompaniedbycomputer-generatedbackgroundmusicusingawithin-subjectsrepeated-measuresdesign.Eachinterventionwasimplementedindividually.Participantscompletedastandardizedattentionassessment,theTestofEverydayAttentionforChildren,beforeandafterbothinterventionstoassesschangesintheirattentionalskills.Theresultsindicatedsignificantimprovementinattentioncontrol/switchingfollowingthemusicinterventionaftercontrollingforthechildren’sintellectualabilities,whilenosuchchangeswereobservedfollowingthevideogameintervention.Thisstudyprovidesthefirstevidencethatmusicinterventionsmaybemoreeffectivethanvideogameinterventionstoimproveattentioncontrolinchildren,andfurthersourunderstandingoftheimportanceofmusicinterventionsforchildrenwithattentioncontrolproblems. Introduction Musicisapowerfulsensorystimulusthatproducesphysiological,psychological,andsocialeffects(Hodges,1996;Davisetal.,2008;ThautandHoemberg,2014;Wheeler,2015).Theclinicalapplicationofmusic,whenutilizedinapurposefulandsystematicway,reportedlyenhancesdevelopmentinspecialneedschildren(Robb,2003a).Althoughtheeffectivenessofmusicinterventionsoncommunication,socialskills,andemotionaldevelopmentinchildrenhasbeenwelldocumented,andtherapeuticeffectsofmusiconcognitioninadultshavealsobeenshown–forexample,onepisodicmemoryinpatientswithdementia(Irishetal.,2006)andtraumaticbraininjuries(Särkämöetal.,2008)focusedattentioninstrokepatients(Särkämöetal.,2008)andsustainedattentioninadultswithcognitivedeficits(Gregory,2002)evidencepertainingtomusic’seffectsonattentionandothercognitivefunctionsinchildrenislimited,andthemechanismsbywhichmusicimprovescognitivefunctionsinchildrenremainpoorlyunderstood. Severalstudieshavereportedthatmusicinterventionsmayhaveapositiveimpactonattention.Ithasbeenproposedthatmusicitselfcontainstherapeuticfactorsthatenhanceattentionskills;forexample,rhythmicpatternsdriveattentionfocus,andmusicalelementssuchasrhythm,melody,andharmonyprovidemultidimensionalstimulithatfacilitateswitchingattention(Gardiner,2005;ThautandGardiner,2014).Theperceptionofrhythmic,melodic,harmonic,anddynamicpatternsinmusicmayinfluencethefocusandorganizationoftheflowofourattention(Thautetal.,2008).Attentionisafundamentalskillforgoodcognitivefunctioningandthusplaysanimportantroleincognitive,social,andcommunicationdevelopment(Muris,2006;vandeWeijer-Bergsmaetal.,2008;CornishandWilding,2010;Matsonetal.,2010;Ruedaetal.,2010;JanzenandThaut,2018).Severalstudiesexaminingpreterminfantshavefoundthatindividualdifferencesinattentionalproblemsearlyindevelopmentcanpredictlatercognitiveandbehavioralfunctioning(vandeWeijer-Bergsmaetal.,2008).Furthermore,attentioncontrolinschool-agechildrenispositivelycorrelatedwithacademicachievement(Muris,2006;Ruedaetal.,2010).Attentionskillsdevelopinastepwisefashionfrominfancythroughengagementwithone’senvironment(RuffandRothbart,2001;AtkinsonandBraddick,2012)exploringtheexternalworld,andorientingto,shiftingbetween,andmaintainingfocusonevents,objects,andtasks(vandeWeijer-Bergsmaetal.,2008).Whenthedevelopmentofthesebasicskillsishindered,theremaybeadverseeffectsoncognitive,social,andcommunicationskills;thus,itisimportanttolearnmoreaboutthepotentialtherapeuticeffectsofmusicinterventiononchildren’sattention. Onlyafewmixedstudieshavereportedontheeffectsofmusicinterventiononchildren’sattention.Forinstance,WolfeandNoguchi(2009)examinedtheeffectsofmusiconsustainedattentionin5-year-oldchildrenusingvigilancetasksthatrequiredverbalandmotorresponses.Thechildrenlistenedtoamusicalorspokenstorywithorwithoutdistraction,andresultsindicatedthatthechildrenlisteningtoamusicalstoryinthedistractionconditionperformedsignificantlybetterthanthechildrenlisteningtoaspokenstorywithdistraction.Mortonetal.(1990)investigated10-to-12-year-oldchildrenusingaverbaldichotomouslisteningtaskthatwasprecededbyexposuretomusicandexposuretosilence.Theauthorsobservedreduceddistractibilityinthechildreninthedirected-reporttaskandincreasedmemorycapacityinthechildreninthefree-reporttask,afterbeingexposedtomusic. Otherstudieshaveinvestigatedmusictherapyinchildrenwithspecialneeds,wheremusicisusedasatherapeutictool.Forexample,Lee(2006)reportedacasestudyofa5-year-oldchildwithautismspectrumdisorder(ASD)whoshowedbetterattentionspaninbehavioralobservationsafter20sessions.Kasuya(2011)reportedacasestudyofan8-year-oldboywithattentiondeficit/hyperactivedisorder(ADHD)whoseattentivebehaviorsimprovedduringmusictherapysessions(measuredwithbehavioralobservations),andsustainedattentionandimpulsivebehaviorsalsoimprovedonacontinuousperformancetaskafter24sessions.Robb(2003b)investigatedattentivebehavioramongsixpreschoolchildrenwithvisualimpairmentsandfoundthatthechildren’sattentivebehaviorsweresignificantlymorefrequentduringmusic-basedsessionsthanduringplay-basedsessions.Knoxetal.(2003)reportedthatabraininjuredadolescentshowedimprovementsinalternatingattentionfollowinginterventionfromaMusicalAttentionTrainingProgram,whichrequiredparticipantstoswitchconcentrationbetweenamelodiclineandadrumtrack.Pasialietal.(2014)examinedtheeffectivenessofastandardizedmusictherapytechnique,MusicalAttentionControlTraining(MACT;ThautandGardiner,2014)innine13-to-20-year-oldadolescentswithvaryingseverityofneurodevelopmentaldelays.Theauthorsfoundpositiveimprovementsinselectiveattentionandattentioncontrolonanattentiontestbatteryaftereightgroupsessions.AbrahamsandvanDooren(2018)alsofoundpositivetrendsinattentiontestsforchildrenwithattentiondeficitsaftersixweeklyMACTsessions.Theypointedout,however,thatthesamplesizewassmall,withonlytwoparticipantsineachoftheexperimentalandcontrolgroups,andthatattentionoutcomesvariedwithindividualparticipants.Althoughthesestudieshaveyieldedlimitedandmixedresultsregardingtheeffectsofmusicinterventionsonchildren’sattention,theysuggestthatmusicmayhaveapositiveimpact.However,noneofthepreviousstudiesevaluatedtheinfluenceofmusicinterventionsondifferenttypesofattention(i.e.sustainedattention,selectiveattention,andattentioncontrol)inmultipleparticipants. Morerecentlongitudinalstudiesconductedinchildrenhavefocusedontheimpactofmusictrainingonnon-musicalcognitivefunctions(MiendlarzewskaandTrost,2014;Benzetal.,2016;Dumontetal.,2017;SalaandGobet,2017).Forexample,Schellenberg(2004)foundgreaterincreasesinfull-scaleIQafteroneyearofkeyboardorvoicelessons.Barbarouxetal.(2019)evaluatedtheimpactofan18-monthclassicmusictrainingprogramonthecognitivefunctionsofchildrenfromlowsocio-economicbackgroundsandfoundsignificantimprovementsingeneralintelligence,processingspeed,concentrationabilities,andreadingprecision.Ontheotherhand,whileLinnavallietal.(2018)foundthatmusicplayschooloverthecourseoftwoschoolyearssignificantlyimprovedphonemeprocessingandvocabularyskills,theydidnotseeimprovementsinnon-verbalreasoningorinhibitorycontrol.Yangetal.(2014)foundthatlong-termmusictrainingsignificantlyimprovedmusicalachievementandsecondlanguagedevelopment,buttherewasnoimprovementinfirstlanguageormathematics.Nanetal.(2018)foundthat6monthsofpianotrainingsignificantlyimprovedauditoryworddiscriminationcomparedtoareadingtrainingoracontrolgroup,however,nodifferenceswerefoundingeneralcognitivemeasures,includingattention,whichimprovedequallyamongthethreegroups.Althoughthesestudieshavereportedmixedevidence,theirfindingssuggestthatlong-termmusicengagementintendedtoimprovemusicalskillshasbeneficialeffectsonnon-musicalfunctions,includingintellectualabilities. Currentlyitisunknownwhethermusicinterventionsdesignedtoimprovechildren’sattentionareeffective.Thus,inthisstudyweexaminedtheeffectofashort-termmusicintervention(i.e.,asingle30-minutetrial)onattentioninchildrenusingatherapeutictechnique,MusicalAttentionControlTraining(ThautandGardiner,2014)asafirststeptowardbroadlyinvestigatingtheeffectivenessofmusictherapyforimprovingcognitivefunctions.Toinvestigatethepureeffectofthemusicintervention,weusedanactivecontrolinterventionwithsimilarfeaturesasthemusicintervention,exceptwithnolivemusic.Thespecificaimswere:(1)toinvestigatetheeffectsofamusicinterventiononchildren’sattentionand(2)toassesswhetherspecificsubtypesofattention(i.e.,sustainedattention,selectiveattention,attentioncontrol/switching,anddividedattention)areresponsivetothismusicintervention.Althoughcertainfactors,suchasintelligenceandADHDtraits,mayaffectattentionalperformance(Manlyetal.,2001;Imadaetal.,2003;CornishandWilding,2010;Hurfordetal.,2017;Mousetal.,2017)nopreviousinvestigationshavecontrolledfortheseinfluences.Thus,weinvestigatedchangesinchildren’sattentionskills(behaviormeasuredbeforeandafteramusicinterventionasanexperimentaltaskandavideogameinterventionasacontroltask)usingastandardizedattentiontest,alongsidetheADHDRatingScale(ADHD-RS;IchikawaandTanaka,2008)andRaven’sColoredProgressiveMatrices(Raven,1998)whichwereadministeredatthestartoftheexperiment.Ourgoalwastoofferinitialinformationregardingtheeffectsofamusicinterventiononchildren’scognitivefunctionsandtoprovideevidenceonthefeasibilityofmusicinterventionsforfutureclinicalresearchwithchildrenwhohavecognitiveimpairment. MaterialsandMethods Participants Participantswererecruitedthroughadvertisementsforhealthychildren,aged6to9years,withoutahistoryofseriousneurologicalillness(e.g.,braininjuries),asconfirmedviaaparentalreport(n=35).Theabove-mentionedagerangewaschosenbecausetheTestofEverydayAttentionforChildren(Manlyetal.,1999)usedinthisstudyhasbeenstandardizedandnormedforchildrenbetweentheagesof6and16.Inaddition,toensurethatthedevelopmentalstageoftheparticipants’workingmemoryandself-awarenesswereassimilaraspossible,childrenunder10yearsofageweretargeted.Thesamplesizewasdeterminedwithreferencetopreviousstudies(Schlaugetal.,2005;Tammetal.,2010;Scott,1992)whichexaminedthepositiveimpactofinterventionsonchildren’scognitivefunctioning.Parentscontactedthefirstauthorbyphoneore-mailtoschedule2daysforparticipationinthisstudy.Onthefirstdayoftheexperiment,withtheirparentspresent,participantswereinterviewedbyanexpertchildpsychiatristtoidentifyanysignsofdevelopmentaldisorders.All35participantscompletedtheexperimentalprocedure,however,sixparticipantswereexcludedfromstatisticalanalysis:threewereexcludedforpossiblyhavingdevelopmentaldisabilities,asassessedbythechildpsychiatristandtheirscoresontheADHD-RSascompletedbytheirparents;theotherthreewereexcludedbecausetheirTEA-Chscoreswereextremeoutliers(morethantwostandarddeviations).Therefore,datafrom29participantswereanalyzed,includingfivepairsofsiblings.Table1showsthedemographiccharacteristicsoftheparticipantswhowereincludedinourstatisticalanalyses. TABLE1 Table1.DemographicCharacteristicsoftheParticipants(n=29). Procedure Anexperimentalwithin-subjectsrepeated-measuresdesignwasused.TheexperimenteradministeredtheTEA-Chtothechildrenpriortoandafterparticipatinginanexperimentaltask(i.e.,musicintervention)andacontroltask(i.e.,videogameintervention),whichwereconductedindividuallyonseparatedaysatleastoneweekapartinaquietofficeattheuniversity. Onthefirstdayofeachexperimentalprocedure,theparticipantandtheparticipant’sparententeredtheoffice,andtheexperimenterverballyexplainedthestudyandprovidedindividualwritteninformedconsentforms;allparticipantsassentedtoparticipateandallparentsconsentedtohavingtheirchild(ren)participatebysigningtheconsentdocument.Next,theparentcompletedtheADHD-RSwhiletheparticipantwasadministeredtheRCPMbytheexperimenter.Then,theparticipantandtheparentwereinterviewedbythechildpsychiatrist.Aftertheinterview,theparentlefttheofficeandtheparticipantwasadministeredtheTEA-Chbytheexperimenterandanassistant.TheTEA-Chhastwoparallelversions,versionA(pre-test)andversionB(post-test),thatallowforassessingtest-takerimprovement;thus,versionAwasadministeredpriortoa30-minutemusicinterventionorvideogameinterventionandversionBwasadministeredaftertheinterventionandabriefbreak(about10min).Iftheparticipantcompletedthemusicinterventiononthefirstday,theycompletedthevideogameinterventiononthesecondday,orviceversa.Interventionorderwascounterbalancedbyalternateassignment,wherehalfoftheparticipantscompletedthemusicinterventionfirst,andtheotherhalfcompletedthevideogameinterventionfirst.Onthesecondday,theparticipantwasadministeredtheTEA-ChversionA,priortothe30-minutemusicorvideogameintervention,andversionBaftertheinterventionandabriefbreak.Totaltimerequiredfortheexperimentswasapproximatelytwo-and-a-halfto3honthefirstdayandtwototwo-and-a-halfhoursonthesecondday.Duringtestandinterventionimplementation,participantswerevideotapedwiththeirparents’permission. Measures ADHDRatingScale-IV(ADHD-RS) TheADHD-RS,originallycreatedbyDuPauletal.(1998)andtranslatedintoJapanesebyIchikawaandTanaka(2008)isan18-itemscalethattakesapproximately5mintocomplete.ItmeasuresADHDsymptomsaccordingtotheDSM-IVdiagnosticcriteria(AmericanPsychiatricAssociation,1994).Eachofthe18itemsisscoredfrom0to3:0=none(neverorrarely);1=mild(sometimes);2=moderate(often);3=severe(veryoften).Weusedthehomeversion,whereaparentreportsthefrequencyofsymptomsoverthepast6months,andobtainedthetotalscorebysummingallscores.Themaximumscorepossibleis54andtheminimumis0,withhigherscoresindicatinggreaterseverityofADHD.Wereferredtothisscorewheninterviewingtheparticipantsandtheirparentsanduseditasacovariatetocontrolforparticipants’ADHDtraits. Raven’sColoredProgressiveMatrices(RCPM) TheRCPM(Raven,1998)isafastandeasy-to-administertestofnon-verbalreasoningusedtoverifythatparticipantshadnointellectualdisabilities.Itcontains36itemsinthreesetstoassessgeneralintellectualdevelopmentforchildrenaged5to11yearsandadults.Eachitempresentsparticipantswithanincompletedesignandsixalternatives;theymustchoosetheonethatbestcompletesthedesign.Weobtainedatotalscorebysummingtheitemsthatwerecorrectlyanswered.Themaximumscoreis36andtheminimumis0,withhigherscoresindicatingbetterperformance.Weusedthisscoreasacovariatetocontrolforparticipants’intellectualabilities. TestofEverydayAttentionforChildren(TEA-Ch) TheTEA-ChwascreatedbyManlyetal.(1999)andincludesninesubtestsofdifferenttypesofskills(e.g.,sustainedattention,selectiveattention,attentioncontrol,andabilitytoinhibitverbalandmotorresponses).Thisassessment,whichisconductedonaone-to-onebasis,hasbeenstandardizedandnormedforchildrenandadolescentsbetweentheagesof6and16.Theassessmenttakesaboutonehourtocomplete;thus,weusedonlythefirstfoursubteststobrieflymeasureeachattentionalfactoranddualtaskperformance(Manlyetal.,1999)withintheallottedtimetoavoidfatiguingthechildren.Thefoursubtestswerecompletedin20to30minandyieldedsevenrawscores,whichwerethenconvertedtoage-scaledscoresbyusingtheappropriatenormativetableprovidedinthetestmanual(Manlyetal.,1999).Theage-scaledscoresforeachsubtestrangefrom1to20,with20representingthebestperformance.Theage-scaledscoreshadameanof10andstandarddeviationof3.Thetoolhastwoparallelversions(versionAandB)toallowfortest-retest.Test-retestreliabilitycoefficientsforthesubtestsrangedfrom0.57to0.87. Thefoursubtestswere(1)“SkySearch”forselective/focusedattention,(2)“Score!”forsustainedattention,(3)“CreatureCounting”forattentioncontrol/switching,and(4)“SkySearchDualTask”(“SkySearchDT”)forsustained-dividedattention. (1)SkySearch.Inthistask,theparticipantisgivenalargesheetfilledwithspaceshippairsanddistractordissimilarspaceshipsandisaskedtofindandcirclepairsofspaceshipsthatarethesameasquicklyaspossible.Thesecondpartofthetask,whichhasnodistractoritems,isusedasacontrolformotorspeeddifferences.Scoringinvolvescountingthenumberofcorrectpairscircledandthetimetaken;atestadministratorrecordstimepertargetbydividingthelatterbytheformer,afterwhichamotorcontrolscoreissubtractedfromthetimepertargetscore.Threescores(“accuracy,”“timepertarget,”and“attentionscore”)areobtainedtomeasurethechild’sselective/focusedattentionskill. (2)Score!Thistaskinvolvessilentlycountingthenumberofshootingsoundsaparticipanthears(rangingfrom9to15)ona6-minuteaudiotrack,withoutusingfingersandwithlonggapsbetweensounds.Therawscoreisobtainedbygivingonepointforeachofthe10trialscountedcorrectly.The“accuracy”scoreisobtainedtomeasurethechild’ssustainedattentionskill. (3)CreatureCounting.Theparticipantcountsthenumberofcreaturesinaburrowinthecuebook,followingavisualpathway—countingupwhenthearrowpointsupanddownwhenitpointsdown.Timetakenandaccuracyforeachoftheseventrialsarerecordedandtwoscores(“accuracy”and“speed”)areobtainedtomeasurethechild’sattentioncontrol/switchingskill. (4)SkySearchDT.Theparticipantperformsthesubtests“Score!”and“SkySearch”atthesametime,meaningtheyvisuallyfindspaceshippairsasquicklyaspossiblewhileauditorilykeepingcountofshootingsoundsontheaudiotrack.Timetakenisrecorded,correctresponsesforbothtasksarecounted,andadualscoreiscalculated.The“decrement”scoreisobtainedtomeasurethechild’ssustained-dividedattentionskill. Tasks Thevideogameinterventionwasadoptedasacontroltaskadministeredundersimilarconditionsastheexperimentaltaskexceptwithnolivemusic.Bothtasks(1)involvedupperextremitymovement,(2)wereinteractivewiththeexperimenter,and(3)wereeasytoplayandchildfriendly.Furthermore,mostchildrenfindbothvideogamesandmusicalinstrumentsenjoyable,andbothactivitiestendtograbchildren’sattention.Forthevideogameintervention,participantsplayedabowlingvideogamefromNintendoWiiSportswiththeexperimenter,whichwasastraight-up,10-pin,10-framegamewithstandardrulesfortwoplayers.TheplayerstookturnsholdingandswingingtheWiiremoteinonehandtorolltheballwithsufficientforceandaimtogetagoodscore.Threeorfoursetsofthegamewereplayedin30min. MusicalAttentionControlTraining(MACT;ThautandGardiner,2014)wasusedastheexperimentalmusicintervention.TheMACTinvolves‘structuredactiveorreceptivemusicalexercisesinvolvingprecomposedperformanceorimprovisationinwhichmusicalelementscuedifferentmusicalresponsestopracticeattentionfunctions’(ThautandGardiner,2014p.257).Inthisstudy,theparticipantplayedpercussioninstrumentswiththeexperimenterwhosang,playedakeyboard,orplayedpercussion.Duringthefirst10min,theexperimenterheldahanddrumineachhand,facingtheparticipant,whoheldamalletineachhand,andaskedtheparticipanttohitthedrumsheldupalternatelybytheexperimenterwiththeleftandrighthand,astheexperimentersangasimple,original“Let’splaythedrum”song.Inthenext10min,theparticipantplayedthreekindsofpercussioninstruments(congas,cymbal,andRemoTubano)asfollows:(1)playedthemfreelywhiletheexperimenterplayedthekeyboard;(2)playedanappropriateoneastheexperimenterplayedhigh,middle,orlowrangeonthekeyboard,followinginstructions(e.g.,askedtoplaythecymbalwhenhearinghighnotes);and(3)playedbymatchinghowtheexperimenterplayedonthekeyboard(e.g.,playedloudlywhentheexperimenterplayedloudlyandstoppedplayingwhentheexperimenterstopped).Inthelast10min,theexperimenterandparticipantfacedeachotherandimitatedeachother’srhythmicpatternswhiletakingturnsonthesamepercussioninstrumentssetbetweenthem.Theseactivitiesimplementedinthemusicinterventionweredesignedaccordingtoourparticipants’agestoeasilyproducerhythmicresponsesagainstaclear,steadybeat(ThautandGardiner,2014). DataAnalysis Afterexcluding6of35participants(asdescribedpreviously),datafromtheremaining29participantswereanalyzedusingIBMSPSSStatistics,version24.0.MeanTEA-Chscoresundereachconditionwerecalculatedforeachparticipant.First,sevenrawscoreswereconvertedtoage-scaledscoresbyusingtheappropriatenormativetablefromthetestmanual(Manlyetal.,1999).Thus,rawdataweretransformedtoanormaldistribution,effectivelyremovingtheinfluenceofage(Manlyetal.,2001)thiswasdonetoexaminewhetherattentionalperformance,includingselective/focusedattention,sustainedattention,attentioncontrol/switching,andsustained-dividedattentionwereinfluencedbythemusicorvideogameinterventions.Sincethefourattentionalperformancesubtestsdonotequallycontributetothescoring,weinvestigatedwhetherattentionalperformancewasmodulatedbythemusicorvideogameinterventionsunderselective/focusedattention,sustainedattention,attentioncontrol/switching,andsustained-dividedattention,separately.Thus: (1)In“SkySearch,”weexamined“accuracy”(subscore1;s1)“timepertarget”(subscore2;s2)and“attentionscore”(subscore3;s3)duringselective/focusedattentiontoassesswhetherattentionalperformancewasmodulatedbythemusicorvideogameinterventions.Scoredifferenceswereanalyzedusingarepeated-measuresanalysisofvariance(ANOVA)withTask(music,game),Time(pre,post),andTEA-ChScore(s1,s2,s3)aswithin-participantfactors. (2)In“Score!,”weexamined“accuracy”(subscore4;s4)duringsustainedattentiontoassesswhetherattentionalperformancewasmodulatedbythemusicorvideogameinterventions.Scoredifferenceswereanalyzedusingarepeated-measuresANOVAwithTask(music,game),Time(pre,post),andTEA-ChScore(s4)aswithin-participantfactors. (3)In“CreatureCounting,”weexamined“accuracy”(subscore5;s5)and“speed”(subscore6;s6)duringattentioncontrol/switchingtoassesswhetherattentionalperformancewasmodulatedbythemusicorvideogameinterventions.Scoredifferenceswereanalyzedusingarepeated-measuresANOVAwithTask(music,game),Time(pre,post),andTEA-ChScore(s5,s6)aswithin-participantfactors. (4)In“SkySearchDT,”weexamined“decrement”(subscore7;s7)duringsustained-dividedattentiontoassesswhetherattentionalperformancewasmodulatedbythemusicorvideogameinterventions.Scoredifferenceswereanalyzedusingarepeated-measuresANOVAwithTask(music,game),Time(pre,post),andTEA-ChScore(s7)aswithin-participantfactors. Ifaninteractionwassignificant,afollow-upsimplemaineffectanalysis(i.e.,assessingtheeffectofeachindependentvariableateachleveloftheotherindependentvariable)wasconductedtointerprettheresult(p<0.05,uncorrectedformultipletests). Finally,toavoidtheinfluenceofindividualcharacteristics,includingparticipants’intellectualabilitiesandADHDtraitsduringselective/focusedattention,sustainedattention,attentioncontrol/switching,andsustained-dividedattention,scoredifferenceswereanalyzedusingrepeated-measuresanalysisofcovariance(ANCOVA)withTask(music,game),Time(pre,post),andTEA-ChScore(e.g.,s1,s2,s3)aswithin-participantfactors,andparticipantRCPMscores,ADHD-RSscores,andRCPMscores×ADHD-RSscoresascovariates. Additionally,weexaminedwhetherattentionalperformancedifferenceswereinfluencedbytaskorder.Theresultsindicatedthatattentionalperformancewasnotmodulatedbytaskorderduringselective/focusedattention,sustainedattention,attentioncontrol/switching,orsustained-dividedattention(seeSupplementaryMaterial). Results Table2showstheaveragedpreandpostage-scaledscoresforeachofthesevensubscores(s1–s7)fromthefourTEA-Chsubtests.Table3showsthedifferenceinTimeconditionbetweenpreandpostduringmusicandvideogameintervention. TABLE2 Table2.MeanScoresforEachSubtestofTEA-ChatPre/PostUsingAge-ScaledScores. TABLE3 Table3.DifferenceinTimeconditionbetweenpre-andpost-testduringthemusicandvideogameinterventions. SkySearchAccuracy,TimeperTarget,andAttentionScore ANOVAs WeconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s1,s2,s3)repeated-measuresANOVA(Figure1andTable3).SignificantmaineffectsweredetectedforTEA-ChScore[F(1,28)=10.906,p<0.001,partialη2=0.447]among11.56,12.741,and12.026,andTime[F(1,28)=15.321,p=0.001,partialη2=0.354]withscoresfrompre(11.609)andpost(12.609),butnotforTask[F(1,28)=0.001,p=0.979,partialη2<0.001]withscoresfrompre(12.115)andpost(12.103).Theresultsthusindicatedthatselective/focusedattentionwasfacilitatedbythemusicandvideogameinterventions. FIGURE1 Figure1.Comparisonofmean(withSE)attentionscoreofTEA-Chbetweenpreandpostmusicandvideogameinterventionsin“SkySearch.”Errorbarsrepresentstandarderrors. ANCOVAs Weusedparticipants’RCPMscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s1,s2,s3)repeated-measuresANCOVA(Table3).SignificantmaineffectwasdetectedforTEA-ChScore[F(1,27)=0.23,p=0.796,partialη2=0.017].NosignificantmaineffectsweredetectedforTask[F(1,27)=0.236,p=0.631,partialη2=0.009]orTime[F(1,27)=2.422,p=0.131,partialη2=0.082],andnosignificantinteractioneffectsweredetectedforTask×RCPM[F(1,27)=0.247,p=0.624,partialη2=0.009],Time×RCPM[F(1,27)=0.846,p=0.366,partialη2=0.03],TEA-Ch×RCPM[F(1,27)=0.388,p=0.682,partialη2=0.029],Task×Time×RCPM[F(1,27)=0.092,p=0.764,partialη2=0.003],Task×TEA-Ch×RCPM[F(1,27)=0.158,p=0.855,partialη2=0.012],Time×TEA-Ch×RCPM[F(1,27)=0.297,p=0.746,partialη2=0.022],orTask×Time×TEA-Ch×RCPM[F(1,27)=1.327,p=0.283,partialη2=0.093].Theresultsthusindicatedthat,whencontrollingforIQtraits,selective/focusedattentionwasnotmodulatedbythemusicorvideogameinterventions. Moreover,weusedparticipants’ADHD-RSscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s1,s2,s3)repeated-measuresANCOVA(Table3).AlthoughnosignificantmaineffectwasdetectedforTask[F(1,27)=2.082,p=0.161,partialη2=0.072]andnosignificantinteractioneffectsweredetectedforTask×ADHD-RS[F(1,27)=3.727,p=0.064,partialη2=0.121],Time×ADHD-RS[F(1,27)=0.616,p=0.439,partialη2=0.022],TEA-Ch×ADHD-RS[F(1,27)=0.178,p=0.838834,partialη2=0.013],Task×TEA-Ch×ADHD-RS[F(1,27)=1.288,p=0.293,partialη2=0.09],Time×TEA-Ch×ADHD-RS[F(1,27)=0.025,p=0.976,partialη2=0.002],orTask×Time×TEA-Ch×ADHD-RS[F(1,27)=0.565,p=0.575,partialη2=0.042],asignificantinteractioneffectwasdetectedforTask×Time×ADHD-RS[F(1,27)=7.229,p=0.012,partialη2=0.211]. Aposthoctestshowedthat,whencontrollingfortheADHD-RSscore,selective/focusedattentionwasfacilitatedbythemusicintervention(p=0.008)withscoresfrompre(11.563)andpost(12.667)andbythevideogameintervention(p=0.007)withscoresfrompre(11.655)andpost(12.552).Theresultsshowedthat,whencontrollingforADHDtraits,“accuracy,”“timepertarget,”and“attentionscore”werefacilitatedbythemusicandvideogameinterventionsduringselective/focusedattention. Finally,weusedparticipants’RCPMscore×ADHD-RSscoreascovariates,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s1,s2,s3)repeated-measuresANCOVA(Table3).AlthoughnosignificantmaineffectwasdetectedforTask[F(1,27)=2.016,p=0.167,partialη2=0.069]andnosignificantinteractioneffectsweredetectedforTask×RCPM×ADHD-RS[F(1,27)=3.689,p=0.065,partialη2=0.12],Time×RCPM×ADHD-RS[F(1,27)=0.36,p=0.553,partialη2=0.013],TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.077,p=0.926,partialη2=0.006],Task×TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.112,p=0.341,partialη2=0.079],Time×TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.032,p=0.969,partialη2=0.002],orTask×Time×TEA-Ch×RCPM×ADHD-RS[F(1,27)=1.036,p=0.369,partialη2=0.074],significantmaineffectsweredetectedforTEA-ChScore[F(1,27)=4.968,p=0.015,partialη2=0.277]andTime[F(1,27)=4.876,p=0.036,partialη2=0.153]andasignificantinteractioneffectwasdetectedforTask×Time×RCPM×ADHD-RS[F(1,27)=6.371,p=0.018,partialη2=0.191]. Aposthoctestshowedthat,whencontrollingforIQandADHDtraits(RCPMandADHDscores),selective/focusedattentionwasfacilitatedbythemusicintervention(p=0.01)withscoresfrompre(11.567)andpost(12.655)andthevideogameintervention(p=0.006)withscoresfrompre(11.631)andpost(12.536).Theresultsshowedthat,whensimultaneouslycontrollingforIQandADHDtraits,“accuracy,”“timepertarget,”and“attentionscore”werefacilitatedbythemusicandvideogameinterventionsduringselective/focusedattention. Score!Accuracy ANOVAs WeconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s4)repeated-measuresANOVA(Figure2andTable3).NosignificantmaineffectsweredetectedforTask[F(1,28)=3.119,p=0.088,partialη2=0.1]withscoresfrompre(10.552)andpost(9.759)orTime[F(1,28)=0.438,p=0.514,partialη2=0.015]withscoresfrompre(10.345)andpost(9.966).Moreover,nosignificantinteractioneffectwasdetectedforTask×Time[F(1,28)=0.921,p=0.345,partialη2=0.032].Theresultsthusindicatedthatsustainedattentionwasnotmodulatedbythemusicorvideogameinterventions. FIGURE2 Figure2.Comparisonofmean(withSE)attentionscoreofTEA-Chbetweenpreandpostmusicandvideogameinterventionsin‘Score!’.Errorbarsrepresentstandarderrors. ANCOVAs Weusedparticipants’RCPMscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s4)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=0.163,p=0.689,partialη2=0.006]orTime[F(1,27)=0.215,p=0.646,partialη2=0.008],andnosignificantinteractioneffectsweredetectedforTask×RCPM[F(1,27)=0.014,p=0.908,partialη2=0.001],Time×RCPM[F(1,27)=0.337,p=0.566,partialη2=0.012],orTask×Time×RCPM[F(1,27)=0.96,p=0.336,partialη2=0.034].Theresultsthusindicatedthat,whencontrollingforIQtraits,sustainedattentionwasnotmodulatedbythemusicorvideogameinterventions. Moreover,weusedparticipants’ADHD-RSscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s4)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=0.1582,p=0.219,partialη2=0.055]orTime[F(1,27)=0.003,p=0.956,partialη2<0.001],andnosignificantinteractioneffectsweredetectedforTask×ADHD-RS[F(1,27)=0.014,p=0.907,partialη2=0.001],Time×ADHD-RS[F(1,27)=0.272,p=0.606,partialη2=0.01],orTask×Time×ADHD-RS[F(1,27)=0.153,p=0.699,partialη2=0.006].Theresultsindicatedthat,whencontrollingforADHDtraits,sustainedattentionwasnotmodulatedbythemusicorvideogameinterventions. Finally,weusedparticipants’RCPMscore×ADHD-RSscoreascovariates,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s4)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=1.861,p=0.184,partialη2=0.064]orTime[F(1,27)=0.019,p=0.892,partialη2=0.001],andnosignificantinteractioneffectsweredetectedforTask×RCPM×ADHD-RS[F(1,27)=0.059,p=0.811,partialη2=0.002],Time×RCPM×ADHD-RS[F(1,27)=0.179,p=0.676,partialη2=0.007],orTask×Time×RCPM×ADHD-RS[F(1,27)=0.151,p=0.701,partialη2=0.006].Theresultsindicatedthat,whensimultaneouslycontrollingforIQandADHDtraits,sustainedattentionwasnotmodulatedbythemusicorvideogameinterventions. CreatureCountingAccuracyandSpeed ANOVAs WeconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANOVA(Figure3andTable3).AsignificantmaineffectwasdetectedforTime[F(1,28)=20.429,p<0.001,partialη2=0.422]withpre(11.155)andpost(12.164)scores,butnosignificantmaineffectsweredetectedforTask[F(1,28)=0.308,p=0.583,partialη2=0.011]withpre(11.784)andpost(11.534)scoresorTEA-Ch[F(1,28)=2.071,p=0.161,partialη2=0.069]withpre(12.103)andpost(11.216)scores.Theresultsindicatedthatattentioncontrol/switchingwasfacilitatedbythemusicandvideogameinterventions. FIGURE3 Figure3.Comparisonofmean(withSE)attentionscoreofTEA-Chbetweenpreandpostmusicandvideogameinterventionsin“CreatureCounting.”Errorbarsrepresentstandarderrors. However,nosignificantinteractioneffectsweredetectedforTask×Time[F(1,28)=0.169,p=0.684,partialη2=0.006],Task×TEA-Ch[F(1,28)=2.355,p=0.136,partialη2=0.078],Time×TEA-Ch[F(1,28)=0.029,p=0.867,partialη2=0.001],orTask×Time×TEA-Ch[F(1,28)=0.789,p=0.382,partialη2=0.027]. ANCOVAs Weusedparticipants’RCPMscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANCOVA(Table3).AlthoughnosignificantmaineffectsweredetectedforTask[F(1,27)=0.248,p=0.623,partialη2=0.009]orTime[F(1,27)=0.429,p=0.518,partialη2=0.016],andnosignificantinteractioneffectsweredetectedforTask×RCPM[F(1,27)=0.357,p=0.555,partialη2=0.013],Time×RCPM[F(1,27)=0.007,p=0.933,partialη2<0.001],Task×Time×RCPM[F(1,27)=0.727,p=0.401,partialη2=0.026],Task×TEA-Ch×RCPM[F(1,27)=0.486,p=0.492,partialη2=0.018],orTime×TEA-Ch×RCPM[F(1,27)=0.518,p=0.478,partialη2=0.019],asignificantmaineffectwasdetectedforTEA-ChScore[F(1,27)=5.241,p=0.03,partialη2=0.163]andsignificantinteractioneffectsweredetectedforTEA-Ch×RCPM[F(1,27)=4.265,p=0.049,partialη2=0.136]andTask×Time×TEA-Ch×RCPM[F(1,27)=8.47,p=0.007,partialη2=0.239]. Inthemusicinterventioncondition,weusedparticipants’RCPMscoreasacovariate,andconductedaTime(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANCOVA.AsignificantmaineffectwasdetectedforTEA-ChScore[F(1,27)=7.184,p=0.012,partialη2=0.21]andsignificantinteractioneffectsweredetectedforTEA-Ch×RCPM[F(1,28)=5.457,p=0.027,partialη2=0.168]andTask×TEA-Ch×RCPM[F(1,28)=4.812,p=0.037,partialη2=0.151].NosignificantmaineffectwasdetectedforTime[F(1,27)=5.457,p=0.23,partialη2=0.053],andnosignificantinteractioneffectsweredetectedforTEA-Ch×RCPM[F(1,28)=5.457,p=0.027,partialη2=0.168]orTime×RCPM[F(1,28)=0.439,p=0.513,partialη2=0.016].Aposthoctestshowedthat,whencontrollingforIQtraits(RCPMscore),“speed”(p=0.003),withscoresfrompre(12.034)andpost(12.931)(p=0.128),butnot“accuracy”(p=0.081),withscoresfrompre(10.414)andpost(11.759)(p=0.128),wasfacilitatedbythemusicinterventionduringattentioncontrol/switching.Theresultsindicatedthat,whencontrollingforIQtraits,“speed”wasfacilitatedbythemusicinterventionduringattentioncontrol/switching. Inthevideogameinterventioncondition,weusedparticipants’RCPMscoreasacovariate,andconductedaTime(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANCOVA.NosignificantmaineffectsweredetectedforTime[F(1,27)=0.068,p=0.797,partialη2=0.002]orTEA-ChScore[F(1,27)=1.985,p=0.17,partialη2=0.068],andnosignificantinteractioneffectsweredetectedforTime×RCPM[F(1,28)=0.43,p=0.518,partialη2=0.016],TEA-Ch×RCPM[F(1,28)=1.798,p=0.191,partialη2=0.062],orTime×TEA-Ch×RCPM[F(1,28)=1.261,p=0.271,partialη2=0.045].Theresultsindicatedthat“accuracy”and“speed”werenotfacilitatedbythevideogameinterventionduringattentioncontrol/switching. Weusedparticipants’ADHD-RSscoreasacovariateandconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANCOVA(Table3).AsignificantmaineffectwasdetectedforTime[F(1,27)=7.53,p=0.011,partialη2=0.218).NosignificantmaineffectsweredetectedforTask(F(1,27)=1.693,p=0.204,partialη2=0.059]orTEA-ChScore[F(1,27)=1.858,p=0.184,partialη2=0.064],andnosignificantinteractioneffectsweredetectedforTask×ADHD-RS[F(1,27)=1.564,p=0.222,partialη2=0.055],Time×ADHD-RS[F(1,27)=0.123,p=0.729,partialη2=0.005],TEA-Ch×ADHD-RS[F(1,27)=0.3,p=0.589,partialη2=0.011],Task×Time×ADHD-RS[F(1,27)=0.407,p=0.529,partialη2=0.015],Task×TEA-Ch×ADHD-RS[F(1,27)=0.816,p=0.374,partialη2=0.029],Time×TEA-Ch×ADHD-RS[F(1,27)<0.001,p=0.991,partialη2<0.001],orTask×Time×TEA-Ch×ADHD-RS[F(1,27)=1.135,p=0.296,partialη2=0.04].Theresultsindicatedthat,whencontrollingforADHDtraits,“accuracy”and“speed”werenotmodulatedbythemusicandvideogameinterventionsduringattentioncontrol/switching. Weusedparticipants’RCPMscore×ADHD-RSscoreascovariates,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s5,s6)repeated-measuresANCOVA(Table3).AsignificantmaineffectwasdetectedforTime[F(1,27)=7.364,p=0.011,partialη2=0.214].NosignificantmaineffectsweredetectedforTask[F(1,27)=1.573,p=0.221,partialη2=0.055]orTEA-ChScore[F(1,27)=2.252,p=0.145,partialη2=0.077],andnosignificantinteractioneffectsweredetectedforTask×RCPM×ADHD-RS[F(1,27)=1.428,p=0.242,partialη2=0.05],Time×RCPM×ADHD-RS[F(1,27)=0.209,p=0.651,partialη2=0.008],TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.517,p=0.478,partialη2=0.019],Task×Time×RCPM×ADHD-RS[F(1,27)=0.28,p=0.601,partialη2=0.01],Task×TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.556,p=0.462,partialη2=0.02],Time×TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.013,p=0.911,partialη2<0.001],orTask×Time×TEA-Ch×RCPM×ADHD-RS[F(1,27)=0.279,p=0.601,partialη2=0.01].Theresultsindicatedthat,whensimultaneouslycontrollingforIQandADHDtraits,“accuracy”and“speed”werenotmodulatedbythemusicandvideogameinterventionsduringattentioncontrol/switching. SkySearchDTDecrement ANOVAs WeconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s7)repeated-measuresANOVA(Figure4andTable3).NosignificantmaineffectsweredetectedforTask[F(1,28)=0.001,p=0.977,partialη2<0.001]withpre(8.655)andpost(8.638)scoresorTime[F(1,28)=1.772,p=0.194,partialη2=0.06]withpre(8.276)andpost(9.017)scores.Moreover,nosignificantinteractioneffectwasdetectedforTask×Time[F(1,28)=1.331,p=0.258,partialη2=0.045].Theresultsindicatedthatsustained-dividedattentionwasnotmodulatedbythemusicorvideogameinterventions. FIGURE4 Figure4.Comparisonofmean(withSE)attentionscoreofTEA-Chbetweenpreandpostmusicandvideogameinterventionsin“SkySearchDT.”Errorbarsrepresentstandarderrors. ANCOVAs Weusedparticipants’RCPMscoreasacovariateandconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s7)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=0.062,p=0.805,partialη2=0.002]orTime[F(1,27)=3.166,p=0.086,partialη2=0.105],andnosignificantinteractioneffectsweredetectedforTask×RCPM[F(1,27)=0.066,p=0.799,partialη2=0.002],Time×RCPM[F(1,27)=2.477,p=0.127,partialη2=0.084],orTask×Time×RCPM[F(1,27)=0.527,p=0.474,partialη2=0.019].Theresultsindicatedthat,whencontrollingforIQtraits,sustained-dividedattentionwasnotmodulatedbythemusicorvideogameinterventions. Moreover,weusedparticipants’ADHD-RSscoreasacovariate,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s7)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=0.093,p=0.763,partialη2=0.003]orTime[F(1,27)=0.799,p=0.379,partialη2=0.029],andnosignificantinteractioneffectsweredetectedforTask×ADHD-RS[F(1,27)=0.192,p=0.664,partialη2=0.007],Time×ADHD-RS[F(1,27)<0.001,p=0.988,partialη2<0.001],orTask×Time×ADHD-RS[F(1,27)=0.005,p=0.943,partialη2<0.001].Theresultsindicatedthat,whencontrollingforADHDtraits,sustained-dividedattentionwasnotmodulatedbythemusicorvideogameinterventions. Finally,weusedparticipants’RCPMscore×ADHD-RSscoreascovariates,andconductedaTask(music,game)×Time(pre,post)×TEA-ChScore(s7)repeated-measuresANCOVA(Table3).NosignificantmaineffectsweredetectedforTask[F(1,27)=0.165,p=0.688,partialη2=0.006]orTime[F(1,27)=0.903,p=0.35,partialη2=0.032],andnosignificantinteractioneffectsweredetectedforTask×RCPM×ADHD-RS[F(1,27)=0.339,p=0.565,partialη2=0.012],Time×RCPM×ADHD-RS[F(1,27)=0.006,p=0.939,partialη2<0.001],orTask×Time×RCPM×ADHD-RS[F(1,27)=0.028,p=0.869,partialη2=0.001].Theseresultsindicatedthat,whensimultaneouslycontrollingforIQandADHDtraits,sustained-dividedattentionwasnotmodulatedbythemusicorvideogameinterventions. Discussion Thepresentstudyexaminedtheeffectofamusicinterventiononhealthychildren’sattention,usingastandardizedattentiontestbattery.Inthemusicintervention,wefoundanenhancedeffectontheresponsespeedofattentioncontrol/switchingwhenparticipants’IQtraitswerecontrolled,comparedtothevideogameintervention.Onselective/focusedattention,resultsshowedthatbothmusicandvideogameinterventionsyieldedsignificantimprovement,however,theeffectsdisappearedwhencontrollingforparticipants’IQtraits.ThesefindingsindicatethatIQtraitsinfluenceattentionalperformance(Manlyetal.,2001;Hurfordetal.,2017)andextendourknowledgebydemonstratingthatIQtraitsalsoinfluenceinterventioneffects.Notably,therewerenoeffectsfoundforsustainedattentionandsustained-dividedattentionundereitherthemusicorvideogameinterventions.Thisisthefirststudytoinvestigatedifferenttypesofattentionwithmultipleparticipants. Ourresultsshowthatthemusicinterventionsignificantlyimprovedchildren’sattentioncontrol/switchingcomparedtothevideogameintervention,evenwhencontrollingforIQtraits.However,whencontrollingforADHDtraits,theeffectsdisappeared.ThismaybebecauseADHD-RSandthissubtestoftheTEA-Chreflectcommonelementsofattention.Ourfindingthatthemusicinterventionimprovedchildren’sattentioncontrolsubstantiatesthepreviousfindingsofPasialietal.(2014)andKnoxetal.(2003)whofoundpositivechangesinadolescentswithneurodevelopmentaldelaysandbraininjuryusingsmallsamplesizes. Inthepresentstudy’smusicintervention,participantswereaskedtoplaypercussioninstrumentsfollowingand/ormatchingtheexperimenter’ssingingorkeyboardplaying.Duringthemusicintervention,participantsfounditnecessarytoswitchtheirattentionauditorilyandvisuallybetweentheexperimenter’ssingingorplayingandtheirownplayingwhilefollowingthetempo,rhythm,andlisteningtothemelodyprovidedbytheexperimenter(ThautandGardiner,2014;Gfeller,2008).Attentioncontrolisdefinedas‘theabilitytoexerteffortfulcontrolinordertoinhibitadominantresponse,toholdinworkingmemorynewlyrelevantrulesthatrequirethesuppressionoractivationofpreviouslylearnedresponses,andtoshiftattentionbetweentasks’(CornishandWilding,2010,p.372).Whenparticipantsplayedthreekindsofpercussioninstrumentstomusic,theyneededtoshifttheirattentiontoplaytheinstrumentswhilefollowingmusicalcuesfromtheexperimenter.Themusicalcuesweremulti-layeredandchangedrandomly;thus,throughouttheactivity,participantsneededtorapidlyshifttheirattentionbackandforthtotherhythmtoplayalongtothebeats,tothepitchtochangetheirinstrument,andtothevolumetochangetheirloudness.Thatis,itwasnotadequatetojustpayattentiontowhattheywereplayingontheirowninstruments;theyalsoneededtochangehowtheyplayed,dependingonthepitch,volume,andtempoofthemusicthatwasproducedbytheexperimenterandtodeterminewhentostart/stop–allofwhichchangedovertime. Activemusiclisteningtoplayalongcouldhaverequiredattentioncontrol,asparticipantsfrequentlyswitchedbackandforthfromeachmusicalelement(Lipscomb,1996).Italsorequiredtheparticipantstoholdtheseinstructionsinworkingmemory;specifically,howtoplayalongwhilefollowingthemusicalcuesandwhentopauseplayingwhenthemusicstopped,whichwerepossiblynewrulesforthem.Insum,referringtotheconceptofattentioncontrol,activeparticipationinthemusicintervention,whileinteractingwiththeexperimenter,requiredparticipantsto:(1)exerteffortfulcontroltoinhibitsteadycontinuousperformanceandfollowandrespondtomusicalcuesthatwerechangingovertime;(2)holdinworkingmemorynewinstructionsonhowtorespondthatwerepossiblydifferentfromtheirpreviousmusicexperience,whichallowedthemtosimplyplayalong;and(3)shifttheirattentionrapidlybetweentheexperimenter/keyboardandtheirinstruments(ThautandGardiner,2014;Lipscomb,1996;Gfeller,2008).Themusicusedinthisstudywasstructuredwithmultipleelementsthatincludedbothverticality(simultaneity)andhorizontality(sequentiality)atthesametime(Thaut,2005)whichmayhaveenhancedparticipants’attentioncontrol.Inconjunctionwiththesepossiblefactors,theunpredictabilityofthemusicinterventionmaybeanotherfactortoconsiderinourresults.Thatis,inthemusicintervention,participantshadtoadapttomusicstimulithatwereprovidedbytheexperimentertorespondappropriatelyovertimeinthetemporalstructure.Thus,comparedtothevideogameintervention,inwhichparticipantsrespondedtorelativelyconstantrequirementsandtookturnsdoingso,themusicinterventionwasmoreunpredictable.Theconstantlychangingnatureofthemusic,includingthevariedelements,couldhaveimpactedattentioncontrol.Thus,thesecomponentsofmusicmaypositivelyinfluenceparticipants’attentioncontrol;hence,musicappearstobeasuitabletoolforattentioncontroltraining. WhencontrollingforIQtraits,thesignificantinterventioneffectsontheselectiveattentionsubtestscoresdisappeared.ThegeneralviewisthatchildrenwithhigherIQsscorebetter,andinthiscase,thechildrenwithhigherIQsfoundthetargetsfasterandmoreaccurately.Infact,differentsearchingstrategieswereobservedinparticipantsduringtesttaking.Forexample,somechildrendartedimpulsivelyfromonepartofthetestsheettoanotherandotherslookedsystematicallythroughthesheetcolumnsoneatatimetofindthetargets.ThismayindicatethatthesedifferingstrategiesareinfluencedbyIQandmayaffectthissubtestscore.Inotherwords,thisattentionsubtypemayinvolveIQfactorsthattheRCPMmeasures,withsomefactorsinfluencingattentionalperformance,dependingontheattentionsubtypes. Withthesubteststhatmeasuredsustainedanddividedattention,nosignificantimprovementswerefoundacrossthemusicandvideogameinterventions.Regardingsustainedattention,ourfindingiscontrarytothoseofpreviousstudies(Robb,2003b;Lee,2006;WolfeandNoguchi,2009;Kasuya,2011).Twopossiblefactorsshouldbeconsidered.First,somestudies(Robb,2003b;Lee,2006;WolfeandNoguchi,2009)investigatedparticipants’sustainedattentionduringoneormoremusicinterventionsorconditions,meaningthatitisunclearwhethertheeffectscanbegeneralizedtoothertasks,likeattentiontests,althoughchildrenexerthighersustainedattentioninmusicalenvironments.Anotherpossibilityisthefrequencyandperiodofinterventionadministration.MorespecificallyKasuya(2011)observedimprovementsonacomputer-basedattentiontestafter24sessionsacross11months.Incontrast,ourfindingisbasedonasingle,shortintervention.Pasialietal.(2014)alsodidnotobservechangesinsustainedattentionaftereightinterventionsacross6weeks.Thissuggeststhatlongerandmorefrequentinterventionsmaybenecessarytoimprovechildren’ssustainedattention.Itislikelythattheinterventionsweemployeddidnotactivatethedividedattentionsubtype. Dataobtainedfromthevariousattentionaltaskssuggestthepossibilityofcross-modaleffectsofmusicinterventiononattention.Thatis,theattentioncontrol/switchingsubtest(“CreatureCounting”),whichrequiredvisualattention,improvedparticipants’performanceafterthemusicintervention.Theperformanceonselectiveattentionsubtest(“SkySearch”)improvedsignificantlyafterbothinterventionsandalsorequiredvisualattention.However,nosignificantimprovementwasfoundintheauditorysustainedattentionsubtest(‘Score!’)norintheauditoryandvisualsustained-dividedattentionsubtest(“SkySearchDT”),followingthemusicintervention,whichisinconsistentwithpreviousfindings(Degéetal.,2011;StraitandKraus,2011).Musicinterventionslikelyrequiremoreauditoryattention,althoughbothinterventionsrequiredvisualattentionaswell;therefore,ourfindingsdidnotsupportourhypothesisthatamusicinterventionwouldimproveauditoryattentionmorethanavideogameintervention.Nevertheless,ourresultssuggestthatattentionisnotamodality-specificfunction.Furthermore,becauseofthemultimodalityofinstrumentalmusicactivity(Pantevetal.,2009)evenwiththelowcomplexityofplayinginstrumentsinourstudy,musicinterventionswithinstrumentshaveyieldedcross-modaleffects(JanzenandThaut,2018).However,somepreviousstudieshavereportednosignificanteffectsofmusicinstrumentlessonsonvisualattention(Straitetal.,2010;Rodenetal.,2014)thus,furtherstudiesareneededtoexaminepotentialcross-modaleffectsofasimplemusicactivity,especiallysincepreviousstudiesthatreviewedtheinfluenceoflong-termmusicaltrainingreportedthatbenefitsmayberestrictedtotheauditorydomain(Rodenetal.,2014;Martensetal.,2015). Theemotionalandmotivationalfactorsassociatedwithmusicareoftenaddressedwhenconsideringtheinfluenceofmusiconchildren’scognitivefunction(ThautandGardiner,2014;Gfeller,2008).Researchfindingsindicatethatthesefactorshelpchildrenfocusandfacilitatelearning(Abikoffetal.,1996;GeistandGeist,2008,2012;Xuetal.,2010).However,ourresultssuggestthatthisoutcomemayberelatedtobothmotivationalandengagingfactorsofmusicandthemusiccomponents,sincethecontrolinterventionemployedinthisstudywasalsomotivationalforchildrenandcontainedengagingfactors.Thisresultsuggeststhatthemusicitself,withitscomponentsdescribedabove,containsfactorsthatenhanceattentioncontrolinchildren,sincethevideogameinterventionwasalsofunandchildfriendly,withanadequateattentionalrequirement.Observationsrevealedthatthecompetingscoresobtainedoneachbowlingturnwiththeexperimenterweremotivationalforparticipantsandelicitedpositiveemotions.Duringthe30-minuteintervention,participantsseemedtoconcentrateonthevideogameinterventionaswellastheydidinthemusicintervention.Previousstudiesthathavefoundeffectsofmusiconattentionintypicalchildren(Mortonetal.,1990;WolfeandNoguchi,2009)comparedmusicconditionstospeechorquietconditions,whicharecontrolconditionsthatmaybelessmotivationalandengagingforchildrenthanthevideogameusedhere.Thus,theresultsofthepresentstudymayreflecttheintrinsicfeaturesofthemusicinterventionmorethantheimpactofemotionalandmotivationalfactorsonattentioncontrol. Previousstudiesshowthatlongitudinalmusictraininginfluencesatleastsomenon-musicalfunctioninginchildren(Yangetal.,2014;Linnavallietal.,2018;Nanetal.,2018;Barbarouxetal.,2019;Fasanoetal.,2019;Schellenberg,2004)however,findingsontheenhancingeffectsoncognitivefunctionsinchildrenhavebeeninconsistent.Onefactorthathascontributedtothisinconsistencymaybedifferencesinmusicalcontent(Dumontetal.,2017)whichvariesgreatlybetweenthestudies,fromgeneralmusicprogramsforyoungchildren(Linnavallietal.,2018)tointenseinstrumentalmusiclessons(Nanetal.,2018).Iftheparticipants’musicalcontentdiffers,bothmusicalandnon-musicalskillsandthebrainregionsandnetworksusedduringmusicengagementlikelydiffer,leadingtodifferentresultsinmeasuredcognitivefunctions.Thepresentstudyexaminedtheeffectsofashort-termmusicinterventiondesignedforattentiontrainingandsetasimilarnon-musicinterventionasanactivecontroltask,withresultsthatcontradictedthoseofsomepreviousstudiesonmusictraining(Scott,1992;Rickardetal.,2010;Degéetal.,2011;Rodenetal.,2014).Forinstance,ourmusicinterventionresultedinsignificantimprovementinattentioncontrolcomparedtothenon-musicalintervention.Itispossiblethatdifferencesinmusicalcontentmayunderlietheinconsistenciesbetweenthepresentstudyresultsandthoseofpreviousstudiesthatfocusedonmusictrainingtolearnmusicand/orinstrumentalperformanceskills. Computerizedprogramsdevelopedspecificallyforattentiontraining(Tuchaetal.,2011;Ruedaetal.,2012;Kirketal.,2016;Spanioletal.,2018)andAttentionProcessTrainingprogramsadaptedforchildren(Kernsetal.,1999;Tammetal.,2013)havebeenextensivelystudied.Incomputerizedprograms,childrenplaygamestotrainvariousattentionskills.However,whilestudiesoncomputerizedprogramshaveshownpromisingeffectsonchildren’sattention,theyhaveyieldedmixedfindingsbyattentionsubtypes,targetedpopulations,andparticipants’ages(Tuchaetal.,2011;Ruedaetal.,2012;Kirketal.,2016).Ourstudyshowsthatinteractivemusicinterventionimprovesattentioncontrol/switchingwhencontrollingforparticipants’IQtraitscomparedtotheactivecontrolintervention,butnopreviousstudiesoncomputerizedprogramshavereportedsimilareffects.Theintrinsicfeaturesofmusicinterventions,suchastheirhighlysocialaspects(Davisetal.,2008;Wheeler,2015)mayhaveinfluencedourresults.Behaviorsresultingfrompoorattentionskillscancauseproblems,mostlyinsocialsituationssuchasintheclassroomorineducationalconversations(DuPauletal.,1998)thus,interactivemusicinterventionsmaybebeneficialforsomechildrenwithattentionaldifficulties.Someresearchershaverecommendedthatattentionrehabilitationshouldinvolveanintervenienttomonitorprogress,givefeedback,andteachstrategies(Gardiner,2005)arguingthatstand-aloneuseofcomputersmaynotbeappropriateforsomechildrenwhoneedattentionrehabilitation(Ciceroneetal.,2000;Weber,1990).Giventhatpreviousfindingsareinconsistentregardingattentionsubtypes,targetedpopulationsandages,andtheintervention’sfrequencyandduration,futureresearchshouldinvestigatewhichprogramsbenefitspecificattentionsubtypesandchildren’sfunctionalattentionskillstodevelopevidence-basedpractices. Thisstudyhasafewlimitations.First,wetargeted6-to-9-year-oldchildren,whoseneuroplasticitywouldhavebeenrelativelyhighinrelationtotheoverallagerangeoftheTEA-Ch(i.e.,6to16years).Thus,thechildren’sagemayhaveinfluencedtheresults.Second,wecautionthereaderagainstgeneralizingourresults,becausethisstudyinvestigatedimmediateandshort-termeffectsofanindividualmusicinterventiononattentionskillsusinganeuropsychologicaltest.Itispossiblethatourresultswereaffectedbychangesinarousalstate,sinceweadministeredtheretestimmediatelyaftertheintervention.Sinceourresultsrepresentafirststeptowarduncoveringtheshort-termeffectsofamusicinterventionontypicallydevelopingchildren,furtherlongitudinalstudiesofattention-targetedmusicinterventionsareneededtoverifythatmusicpositivelyimpactsnon-musicalattentivebehaviors.Futurestudiesshouldfollowthechild’sprogressonattentionalperformanceandexaminewhetherinterventioneffectsaregeneralizabletoattentionalperformanceintherealworldforbothtypicallydevelopingchildrenandchildrenwithattentionaldeficits. Itisalsonecessarytoexaminethetransfereffectsofmusicinterventionsbeyondthescopeofthisstudytodiscoverwhetherattention-targetedmusicinterventionsinfluenceotherfunctionsbeyondattention,comparedtonon-musicinterventions.Sinceattentionskillsunderliehighercognitivefunctionsandcouldpossiblyaffectoverallchilddevelopment,futurestudiesshouldexaminewhetherattentioncontrolimprovementsdrivenbymusicintervention,asfoundinthepresentstudy,havealong-terminfluenceonothercognitivefunctions,suchasgeneralintelligenceandexecutivefunction.Forthosewithattentionaldeficits,especiallyindividualswithADHDandASD,whoareoftenobservedtohaveattentioncontroldifficulties(Fan,2013;Townsendetal.,1996;AllenandCourchesne,2001;Goldsteinetal.,2001;Rinehartetal.,2001;LandryandBryson,2004;Zwaigenbaumetal.,2005;CornishandWilding,2010)weneedtoinvestigatewhethertheeffectsofmusicinterventionsinfluencetheircoresymptoms.GiventhatchildrenwithASDhaveshownimprovementsinsocialcommunicationfollowinginterventionstoimproveattention(Matsonetal.,2010;Kernsetal.,2017)transfereffectsofmusicinterventiontootherdomains(i.e.,socialandcommunicationdomains)shouldalsobeinvestigated.ChildrenwithADHD,whopotentiallyhavecoredeficitswithtrackingthebeatofmusic(Puyjarinetetal.,2017)maybenefitfrommusicinterventionswithrhythm-basedactivities,suchasemployedinthepresentstudy,overbackgroundmusicintervention(MaloyandPerterson,2014)becausechildrenwhocansynchronizetorhythmdisplaybetterattentivebehaviors(Khaliletal.,2013).Aninterventionwithsimpleandeasy-to-followmusicalactivities,likethoseusedinthisstudy,shouldbefeasibletoimplementforchildrenwithcognitiveimpairmentsand/ordevelopmentaldisorders(Pasialietal.,2014;AbrahamsandvanDooren,2018).Thesepossibilitieswillbethefocusoffuturestudiesinmusicinterventions. AlthoughthestudybyRuedaetal.(2005)showedthatattentionnetworkdevelopmentissubjecttointerventionsduringchildhood,resultsfromwidelyimplementedattentiontrainingprograms(e.g.,computerizedtraining)havebeeninconsistent.Ourresults,coupledwithalimitednumberofpreviousstudieswithsmallsamplesizes,showthatmusicinterventionsmayhavepositiveimpactsonchildren’sandadolescents’attention.Currently,thereisnogoldstandardforattentiontrainingandthebestandmosteffectiveapproachesmaydiffer,dependingonthechild’sage,diagnosis,andseverityoftheattentiondeficit.Additionally,infuturestudiesofattention,werecommendthatresearchersuncoverdetailsofparticipants’pastexperienceswiththeresearchtasks,sincefamiliaritymayinfluencetheoutcomes.Itispossiblethatthelevelofattentionandcognitiveloadmaybedifferentforafirst-timeactivitythanforanexperiencedactivity. Finally,anotherlimitationshouldbenoted:implementingmusicinterventionswithchildrenrequiresmanycompetencies,suchasmusicalandteachingskills,andtheabilitytointeract,bemotivating,andbuildgoodrelationships.Giventhatweonlyimplementedaone-timemusicintervention,itislikelythattherewerenoeffectsfromtheintervener-childrelationship,however,theintervener’scompetencemayalsohaveinfluencedourstudyresults(Standley,2000).Thus,infuturestudies,itwillbenecessarytoinvestigatewhetherintervenerfactors(e.g.,yearsofexperienceandeducationhistory)influenceinterventioneffects. Conclusion Ourfindingsindicatethatamusicinterventionhasshort-termeffectsonchildren’sattentioncontrol.Thisisthefirstevidenceshowingthataninteractiveinterventionwithlivemusicinwhichachildplaysaccessibleinstrumentsmaybenefitattentioncontrol.Ourresultssuggestthatmusicinterventionmaybeapromisingtooltotrainattentioncontrolinchildrenbyelicitingunderlyinginducedoscillatoryactivityassociatedwithattentionalabilityandneuroplasticity(Trainoretal.,2009;ThautandGardiner,2014).Giventhatpreviousstudieshavereportedsimilarneurologicalobservationsfollowinglong-termmusicalengagement(Schlaugetal.,2005,2009;Hydeetal.,2009)neuroimagingstudiesareneededtoexaminetheeffectsofmusiconbrainactivityandtodeepenourunderstandingofhowmusicimproveschildren’scognitivefunction.Ourfindingsnotonlyprovideevidencefortheeffectivenessofmusicintervention,theyalsoprovidecluestowardunderstandingitsneuralmechanisms. DataAvailabilityStatement Alldatasetsgeneratedforthisstudyareincludedinthearticle/SupplementaryMaterial. EthicsStatement ThestudiesinvolvinghumanparticipantswerereviewedandapprovedbytheethicscommitteeofKyotoUniversityGraduateSchoolofMedicineinaccordancewiththeDeclarationofHelsinki(approvalnumber:E1856),andallmethodswereimplementedinaccordancewithrelevantguidelinesandregulations.Writteninformedconsenttoparticipateinthisstudywasprovidedbytheparticipants’legalguardian/nextofkin. AuthorContributions YK-UandMTdevelopedthestudymethodsanddesign.YK-Ucollectedthedata,conductedtheexperiment,andwrotethemanuscript.MTinterviewedtheparticipantsandtheirparents.SZperformedthestatisticalanalyses.Allauthorscontributedtothemanuscriptpreparation. Funding ThisresearchwasconductedwithfinancialsupportfromJSPSKAKENHIGrantNumber24700573. ConflictofInterest Theauthorsdeclarethattheresearchwasconductedintheabsenceofanycommercialorfinancialrelationshipsthatcouldbeconstruedasapotentialconflictofinterest. Acknowledgments Wewouldliketoshowourgreatestappreciationtotheparticipantsandtheirparentsfortheirtimeandcooperation.WethankMs.EmiYokoyamaforherconsiderablesupportasanexperimentalassistantandDr.BlytheLaGasse,ProfessoratColoradoStateUniversity,forhermeticulouscomments.WewouldalsoliketothankEditageforEnglishlanguageediting.Withouttheinvaluableandenormoushelpofallthesepeople,thisarticlewouldnothavebeenmaterialized. 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Editedby: MichaelH.Thaut,UniversityofToronto,Canada Reviewedby: MireilleBesson,InstitutdeNeurosciencesCognitivesdelaMéditerranée(INCM),France LauraDamianiBranco,PontificalCatholicUniversityofRioGrandedoSul,Brazil Copyright©2020Kasuya-Ueba,ZhaoandToichi.Thisisanopen-accessarticledistributedunderthetermsoftheCreativeCommonsAttributionLicense(CCBY).Theuse,distributionorreproductioninotherforumsispermitted,providedtheoriginalauthor(s)andthecopyrightowner(s)arecreditedandthattheoriginalpublicationinthisjournaliscited,inaccordancewithacceptedacademicpractice.Nouse,distributionorreproductionispermittedwhichdoesnotcomplywiththeseterms. *Correspondence:YukaKasuya-Ueba,[email protected];ShuoZhao,[email protected] COMMENTARY ORIGINALARTICLE Peoplealsolookedat SuggestaResearchTopic>