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Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance.

Schlund MW, Cataldo MF, Siegle GJ, Ladouceur CD, Silk JS, Forbes EE, McFarland A, Iyengar S, Dahl RE, Ryan ND - Behav Brain Funct (2011)

Bottom Line: However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem.We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols.The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh PA, USA. schlund@kennedykrieger.org

ABSTRACT

Background: Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI) research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population.

Method: In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 9-13 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N=120). Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress.

Results: Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations.

Discussion: We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks.

Conclusion: The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols.

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Related in: MedlinePlus

Visual progress display presented during neuroimaging rest periods. Informational display highlighting each experimental task, a progress bar and subject-identified rewards earned for completing tasks. The display was presented between imaging tasks and functioned as a supplement to researcher's instructions and verbal praise/encouragement for participation. Tasks are listed by imaging runs, such that those requiring multiple runs are listed multiple times. Task-paired rewards, listed as 'prizes,' were identified prior to neuroimaging using a preference assessment procedure and were earned contingent upon task completion, regardless of performance accuracy. The progress bar descended after a task was completed.
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Figure 1: Visual progress display presented during neuroimaging rest periods. Informational display highlighting each experimental task, a progress bar and subject-identified rewards earned for completing tasks. The display was presented between imaging tasks and functioned as a supplement to researcher's instructions and verbal praise/encouragement for participation. Tasks are listed by imaging runs, such that those requiring multiple runs are listed multiple times. Task-paired rewards, listed as 'prizes,' were identified prior to neuroimaging using a preference assessment procedure and were earned contingent upon task completion, regardless of performance accuracy. The progress bar descended after a task was completed.

Mentions: Considerable developmental research shows age-related improvements in memory and information processing speed and reductions in susceptibility to interference [30,31]. Within any neuroimaging investigation, children are exposed to a wealth of information and demands that can be overwhelming and aversive, prompting noncompliance. Researchers routinely manage task information and demands using verbal communication during imaging rest periods, informing subjects about current and upcoming tasks as well as providing reassurance about progress (e.g., "You finished that task. Just three more tasks left. You are doing great!"). Accordingly, the third element of the multiple reward compliance protocol involves supplementing verbal communications with a visual presentation that highlights information about tasks, demands and progress. Figure 1 provides an illustration of a visual progress display we presented to subjects during imaging rest periods, which can be easily created and presented using Microsoft Word®, Powerpoint® or programmed using Eprime®. The format presents information about the pairing of tasks with subject-identified rewards and current progress. Each task is listed (under 'Jobs') and separated by imaging run, such that tasks requiring multiple imaging runs are listed multiple times. In the center of the display is a progress bar the researcher can advance downward toward a 'finish line' after each task is completed. Presentation of the visual display during breaks enables subjects to quickly observe their progress, tasks, earned rewards and upcoming rewards. The information provided about upcoming tasks may also insulate against the development of negative affective responses associated with the uncertainty of future events and provide an increased sense of control. At least one published protocol has employed a version of this approach with a "virtual sticker chart" that highlights progress [17]. One strength behind the sticker chart approach is the progress information it provides. However, a potentially important weakness is that stickers provided may lack rewarding or reinforcing properties for some subjects.


Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance.

Schlund MW, Cataldo MF, Siegle GJ, Ladouceur CD, Silk JS, Forbes EE, McFarland A, Iyengar S, Dahl RE, Ryan ND - Behav Brain Funct (2011)

Visual progress display presented during neuroimaging rest periods. Informational display highlighting each experimental task, a progress bar and subject-identified rewards earned for completing tasks. The display was presented between imaging tasks and functioned as a supplement to researcher's instructions and verbal praise/encouragement for participation. Tasks are listed by imaging runs, such that those requiring multiple runs are listed multiple times. Task-paired rewards, listed as 'prizes,' were identified prior to neuroimaging using a preference assessment procedure and were earned contingent upon task completion, regardless of performance accuracy. The progress bar descended after a task was completed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3113722&req=5

Figure 1: Visual progress display presented during neuroimaging rest periods. Informational display highlighting each experimental task, a progress bar and subject-identified rewards earned for completing tasks. The display was presented between imaging tasks and functioned as a supplement to researcher's instructions and verbal praise/encouragement for participation. Tasks are listed by imaging runs, such that those requiring multiple runs are listed multiple times. Task-paired rewards, listed as 'prizes,' were identified prior to neuroimaging using a preference assessment procedure and were earned contingent upon task completion, regardless of performance accuracy. The progress bar descended after a task was completed.
Mentions: Considerable developmental research shows age-related improvements in memory and information processing speed and reductions in susceptibility to interference [30,31]. Within any neuroimaging investigation, children are exposed to a wealth of information and demands that can be overwhelming and aversive, prompting noncompliance. Researchers routinely manage task information and demands using verbal communication during imaging rest periods, informing subjects about current and upcoming tasks as well as providing reassurance about progress (e.g., "You finished that task. Just three more tasks left. You are doing great!"). Accordingly, the third element of the multiple reward compliance protocol involves supplementing verbal communications with a visual presentation that highlights information about tasks, demands and progress. Figure 1 provides an illustration of a visual progress display we presented to subjects during imaging rest periods, which can be easily created and presented using Microsoft Word®, Powerpoint® or programmed using Eprime®. The format presents information about the pairing of tasks with subject-identified rewards and current progress. Each task is listed (under 'Jobs') and separated by imaging run, such that tasks requiring multiple imaging runs are listed multiple times. In the center of the display is a progress bar the researcher can advance downward toward a 'finish line' after each task is completed. Presentation of the visual display during breaks enables subjects to quickly observe their progress, tasks, earned rewards and upcoming rewards. The information provided about upcoming tasks may also insulate against the development of negative affective responses associated with the uncertainty of future events and provide an increased sense of control. At least one published protocol has employed a version of this approach with a "virtual sticker chart" that highlights progress [17]. One strength behind the sticker chart approach is the progress information it provides. However, a potentially important weakness is that stickers provided may lack rewarding or reinforcing properties for some subjects.

Bottom Line: However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem.We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols.The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh PA, USA. schlund@kennedykrieger.org

ABSTRACT

Background: Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI) research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population.

Method: In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 9-13 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N=120). Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress.

Results: Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations.

Discussion: We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks.

Conclusion: The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols.

Show MeSH
Related in: MedlinePlus