Cognitive remediation in ADHD: Effects of periodic non-contingent alerts on sustained attention to response

Abstract

Few studies have attempted direct cognitive remediation of attention deficits in attention-deficit hyperactivity disorder (ADHD). The present study investigated the efficacy of periodic non-informative alerting cues for improving sustaining attention in ADHD. This technique is known to improve sustained attention in right frontal injury patients and may be effective in ADHD, given that this disorder has also been linked with right frontal dysfunction. Fifteen children with ADHD and 15 matched controls completed four blocks of a modified version of the Sustained Attention to Response Task (SART). Eight random non-contingent alerts were introduced on two of these blocks as a cue for participants to adopt a more supervisory stance to their performance. While the alerting cues did not alter the total number of commission errors committed by ADHD children over a task block, they did produce a significant short-term reduction in commission errors in the period immediately following an alerting cue. Our data demonstrate that sustained attention performance can be enhanced in children with ADHD using a simple cognitive training strategy. Methods from the field of cognitive rehabilitation may be viably applied to the remediation of attention deficits in ADHD.

Acknowledgments

The work reported herein was supported by the Government of Ireland Research Scholarship in the Humanities and Social Sciences to R. G. O'Connell and is administered by the Irish Research Council for the Humanities and Social Sciences.

Notes

¹Based on frequency of occurrence of participants with achievement scores within each of the Borderline, Low Average, Average, High Average, Superior and Very Superior categories (as defined within the WRAT3).

²These data were reported previously in O'Connell et al. (2004).

³It should be noted that the comparatively low number of commission errors and the small number of alerts presented effectively precluded an accurate analysis of error probability relative to alert presentation in the control group.