The Effectiveness of Attention Training on Total Attentional Functions in Children with Attention-Deficit/Hyperactivity Disorder

Authors
Nahid Nikpour
S. M. Hossein Mousavi Nasab
Masoud Fazilat-Pour
Shahid Bahonar University of Kerman
Abstract
Introduction

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood. Attention is one of the most important cognitive functions which is impaired in children with ADHD that can affect the future educational, social and occupational functions of these children. The aim of this study was to investigate the effectiveness of attention training on attentional functions in children with ADHD.

Materials and Methods

The method of this study was semi- experimental with purposive sampling with pre-test and post-test for control group. For this aim, 40 male students were diagnosed as ADHD who were selected by clinical interview and Conner's questionnaire and randomly 20 participants were assigned in the experimental group and 20 were assigned in the control group. In order to measure the variables of the research, Stroop task, continuous performance test, Wisconsin Card Sorting test, and divided attention test were used. Attention training was presented on the experimental group in 8 sessions, using a set of related cognitive games and attention-based task .For data analysis, covariance analysis was used.

Results

The results indicated that attention training significantly increased the sustained attention performance and response inhibition of children with ADHD, but there was no significant effect on the selective attention function, shifting attention and divided attention.

Conclusion

According to the findings, the present training package can be used to improve sustained attention and response inhibition in children with ADHD.
Keywords
Attention Deficit Hyperactivity Disorder
Attention
Cognition
1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5): American Psychiatric Pub; 2013.
2. Sadock BJ, Sadock VA, Ruiz R. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Tehran: Arjmand; 2016. [persian]
3. Black DW, Grant JE. DSM-5 Guidebook the essential: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders. Tehran: Arjmand; 2015. [persian]
4. Mash EJ, Wolfe DA. Abnormal child psychology. Belmont, CA: Wadsworth CENGAGE Learning; 2010.
5. Sohlberg MM, Mateer CA. Improving attention and managing attentional problems. Ann N Y Acad Sci. 2001;931(1):359-75.
6. Lezak MD, Howieson DB, Loring DW, Fischer JS. Neuropsychological assessment: Oxford University Press, USA; 2004.
7. Sturm W, Willmes K, Orgass B, Hartje W. Do specific attention deficits need specific training? Neuropsychol Rehabil. 1997;7(2):81-103.
8. Ilieva IP, Hook CJ, Farah MJ. Prescription stimulants' effects on healthy inhibitory control, working memory, and episodic memory: a meta-analysis. J Cogn Neurosci. 2015;27(6):1069-89.
9. Tenenbaum RB, Musser ED, Morris S, Ward AR, Raiker JS, Coles EK, Pelham WE. Response inhibition, response execution, and emotion regulation among children with attention-deficit/hyperactivity disorder. J Abnorm Child Psychol. 2019;47(4):589-603.
10. Miranda A, Presentación MJ, Siegenthaler R, Jara P. Effects of a psychosocial intervention on the executive functioning in children with ADHD. Learn Disabil Q. 2013;46(4):363-76.
11. Tamm L, Nakonezny PA. Metacognitive executive function training for young children with ADHD: A proof-of-concept study. Atten Defic Hyperact Disord. 2015;7(3):183-90.
12. Kesler SR, Lacayo NJ, Jo B. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain Injury. 2011;25(1):101-12.
13. Bennett T, Raymond M, Malia K, Bewick K, Linton B. Rehabilitation of attention and concentration deficits following brain injury. Journal of Cognitive Rehabilitation-Including Free Diskette. 1998;16(2):8-13.
14. Robatmili S, borjali A, Alizade H, Nokani M, N. F. The Effectiveness of Cognitive Rehabilitation on Response Inhibition in Children with Attention Deficit- Hyperactivity Disorder (predominantly inattentive type). Psychology of exceptional people. 2015; 19:1-22. [persian]
15. Nokani M. Cognitive rehabilitation using computer in reducing the attention deficits of attention deficit/ hyperactivity disorder (predominantly inattentive type), (Dissertation for the degree of Doctor of philosophy): University of Social Welfare and Rehabilitation Sciences; 2010. [persian]
16. Najarzadegan M, Nejati V, Amiri N, Sharifian M. Effect of cognitive rehabilitation on executive function (working memory and attention) in children with Attention Deficit Hyperactivity Disorder. J Rehab Med. 2015;4(2):97-108. [persian]
17. Tamm L, Epstein JN, Peugh JL, Nakonezny PA, Hughes CW. Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD. Dev Cogn Neurosci. 2013; 4:16-28..
18. Tamm L, Hughes C, Ames L, Pickering J, Silver CH, Stavinoha P, Castillo CL, Rintelmann J, Moore J, Foxwell A, Bolanos SG. Attention training for school-aged children with ADHD: Results of an open trial. J Atten Disord. 2010 Jul;14(1):86-94.
19. Tucha O, Tucha L, Kaumann G, König S, Lange KM, Stasik D, et al. Training of attention functions in children with attention deficit hyperactivity disorder. Atten Defic Hyperact Disord. 2011;3(3):271-83.
20. Cortese S, Ferrin M, Brandeis D, Buitelaar J, Daley D, Dittmann RW, Holtmann M, Santosh P, Stevenson J, Stringaris A, Zuddas A. Cognitive training for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. J AM ACAD CHILD PSY. 2015;54(3):164-74.
21. khodam R. Guide to the use of generic drugs in Iran. Tehran: Dibaj; 2010. [persian]
22. Shahaeian A, Shahim S, L. B, Yousefi F. Standardization, Factor Analysis and Reliability of Parents Short Form Conners Scale for Children 6-11 Years Old in Shiraz. Journal of Psychological Studies. 2007;3(3):97-120. [persian]
23. Conners C. Manual for Conners’ Rating Scales. Conners’ Teacher Rating Scales, Conners’ Parent Rating Scales. New York: Multi-Health Systems. Inc; 1997.
24. Shahim S, Yousefi F, Shahaeian A. Standardization and Psychometric Properties of the Conners Scale - Teacher Form. Journal of Educational Sciences and Psychology. 2008;14(1-2):1-26. [persian]
25. Khodadadi M, Mashhadi A, Amani H. Simple stroop software. Tehran: Sina Cognitive Behavioral Sciences Research Institute 2014. [persian]
26. Sergeant JA, Geurts H, Oosterlaan J. How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behavioural brain research. 2002;130(1-2):3-28.
27. Shahgholian M, Azadfalah P, Fathi Ashtiani A, Khodadadi M. Design of the Wisconsin Card sorting Test Software (WISC): Theoretical Foundations, Construction Methods and Psychometric Properties. Quarterly Journal of Clinical Psychology. 2011;4(11):111-33. [persian]
28. Hadianfard H, Najarian B, Shokrkon H, Mehrabizade-Honarmand M. construction and validation of the farsi version the continuous performance test. Journal of psychology. 2001;4(4):388-404. [persian]
29. Kerns KA, Eso K, Thomson J. Investigation of a direct intervention for improving attention in young children with ADHD. Dev Neuropsychol. 1999;16(2):273-95.
30. Heaton SC, Reader SK, Preston AS, Fennell EB, Puyana OE, Gill N, et al. The Test of Everyday Attention for Children (TEA-Ch): Patterns of performance in children with ADHD and clinical controls. Child Neuropsychol. 2001;7(4):251-64.
31. Van der Oord S, Ponsioen A, Geurts H, Brink ET, Prins P. A pilot study of the efficacy of a computerized executive functioning remediation training with game elements for children with ADHD in an outpatient setting: outcome on parent-and teacher-rated executive functioning and ADHD behavior. J Atten Disord. 2014;18(8):699-712.
32. Lawrence V, Houghton S, Douglas G, Durkin K, Whiting K, Tannock R. Executive function and ADHD: A comparison of children’s performance during neuropsychological testing and real-world activities. J Atten Disord. 2004;7(3):137-49.
33. Grodzinsky GM, Diamond R. Frontal lobe functioning in boys with attention‐deficit hyperactivity disorder. Dev Neuropsychol. 1992;8(4):427-45.
34. Koschack J, Kunert H, Derichs G, Weniger G, Irle E. Impaired and enhanced attentional function in children with attention deficit/hyperactivity disorder. Psychol Med. 2003;33(3):481-9.
35. Greimel E, Wanderer S, Rothenberger A, Herpertz-Dahlmann B, Konrad K, Roessner V. Attentional performance in children and adolescents with tic disorder and co-occurring attention-deficit/hyperactivity disorder: new insights from a 2× 2 factorial design study. J Abnorm Child Psychol. 2011;39(6):819-28.
36. Inasaridze K, Bzhalava V. Dual-task Coordination in Children and Adolescents with Attention Deficit Hyperactivity Disorder (ADHD). arXiv preprint arXiv:11011858. 2011.
37. Rabiner DL, Murray DW, Skinner AT, Malone PS. A randomized trial of two promising computer-based interventions for students with attention difficulties. J Abnorm Child Psychol. 2010;38(1):131-42.
38. Shalev L, Tsal Y, Mevorach C. Computerized progressive attentional training (CPAT) program: effective direct intervention for children with ADHD. Child Neuropsychol. 2007;13(4):382-8.
39. Steiner NJ, Sheldrick RC, Gotthelf D, Perrin EC. Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial. Clin Pediatr (Phila). 2011;50(7):615-22.
40. Azami s, Moghadas A, Sohrabi F. Comparison of the effect of computer rehabilitation and stimulant drugs on response inhibition and sustained attention of children with attention deficit/ hyperactivity disorder. Journal of Exceptional people. 2013;3(11):21-39. [persian]
41. Nazifi M, Rasoolzadeh-Tabatabaie K, Azadfallah P, Moradi A. The Effect of Computer-Assisted Cognitive Rehabilitation and Drug Therapy on Response Inhibition and Reaction Time of Children with Attention Deficit/Hyperactivity Disorder. Journal of Clinical Psychology. Journal of Clinical Psychology. 2012;4(13):87-99. [persian]