title: Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh PA, USA. schlund@kennedykrieger.org
authors.forename: Michael W
authors.initials: MW
authors.lastname: Schlund
authors.forename: Michael F
authors.initials: MF
authors.lastname: Cataldo
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Siegle
authors.forename: Cecile D
authors.initials: CD
authors.lastname: Ladouceur
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Silk
authors.forename: Erika E
authors.initials: EE
authors.lastname: Forbes
authors.forename: Ashley
authors.initials: A
authors.lastname: McFarland
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001931:Brain Mapping / Q000379:methods*; D002648:Child; D003216:Conditioning, Operant; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011597:Psychomotor Performance; D012107:Research Design; D012201:Reward