The Status of Empirical Support for Treatments of Attention Deficits

Abstract

Deficits in attention and self-regulation are common complaints associated with a number of disorders across the lifespan. The need to address attentional deficits is based on the premise that attention is a precursor and prerequisite to information processing and related cognitive tasks as well as a key factor in the success of other rehabilitation efforts. Many treatment programs have been developed with the intention of restoring or rehabilitating the impaired components of attention; the number and variety of attention programs is increasing rapidly. The purpose of this article is to evaluate available empirical support regarding the efficacy of treatments for remediation of attention deficits across disorders and age levels. The search of the major databases yielded 83 studies that included treatment of attentional deficits. Empirical studies were reviewed and categorized by the type of trial, whether or not the study included a control group, and the nature of the control group. The methodology and results of each study were then rated. For each treatment identified, the aggregated studies were then considered by the disorder of the samples included in the studies. Results indicated that, regardless of the treatment program or population, the existing research does not provide sufficient evidence to reach any conclusions about the efficacy of programs designed to address attention deficits. Before any conclusions, positive or negative, can be drawn, there is a need for more rigorous study of available treatment programs across age levels and disorders, with sufficient baseline and outcome data as well as control or alternative treatment conditions.

Prepared for the Committee on Empirically Supported Programs (COESP), Division 40: Neuropsychology of the American Psychological Association.

Notes

¹For ease of readability, attention deficit hyperactivity disorder (ADHD) is used in this manuscript for all previous names of the attention deficit disorders, with or without hyperactivity, and hyperkinesis.

Based on Heaton et al. (2002).

ADHD = attention deficit hyperactivity disorder.

ADHD = attention deficit hyperactivity disorder; MR = mental regardation; TBI = traumatic brain injury.

ADHD = attention deficit hyperactivity disorder; MR = mental regardation; TBI = traumatic brain injury.

Includes studies using electroencephalography (EEG), electromyography (EMG), and cerebral blood flow feedback. ADHD = attention deficit hyperactivity disorder; LD = learning disability; MR = mental retardation; RD = reading disability.

TBI = traumatic brain injury.

^aResults were positive; however, multiple treatment components were implemented simultaneously.

TBI = traumatic brain injury.

^aResults were positive; however, three programs were used simultaneously and no control of treatment was undertaken.

ADHD = attention deficit hyperactivity disorder; SED = serious emotional disturbance.

^aResults were positive; however, three training programs were used simultaneously and no control of treatment was undertaken.

ADHD = attention deficit hyperactivity disorder; LD = learning disability; MR = mental retardation; TBI = traumatic brain injury.

^aNo program was found to have this level of empirical support for any population.