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Researcher of the Month

Do sustained attention training interventions actually work?

This month, we are highlighting a recent paper by Dr Éadaoin Slattery and co-authors, which systematically reviews the evidence behind three popular sustained attention training approaches widely used in schools with children and teens between the ages of three and 18.

Attention is a cognitive process that is fundamental to learning and functioning and is vital for our performance on monotonous tasks. Sustained attention refers to the ability to continuously maintain focus on goal-directed activity over time, particularly in conditions of monotony and repetition. In everyday life, we’d commonly refer to ‘sustained attention’ as concentration or focus. Sustained attention skills develop throughout childhood, with a period of accelerated development occurring between the ages of around six to nine years.

Correlational research shows that sustained attention is related to children’s academic achievement in key domains such as maths. We also know that children with sustained attention difficulties, such as those with ADHD, are at increased risk of lower grades, dropping out of school early and having to repeat a school year. Students with attentional difficulties can also be at higher risk of experiencing social and emotional issues, including teasing from peers, and lower self-esteem.

Because of its importance, many schools implement sustained attention training interventions. Dr Slattery evaluates the existing evidence base for three common intervention approaches – cognitive attention training (commonly known as brain training), physical activity, and meditation training. She seeks to establish whether any of these interventions actually improve performance on both sustained attention tasks and other cognitive tasks, as well as their impact on behavioural measures (such as ADHD symptoms).

Summary

In the last few years, studies of interventions promoting activities designed to enhance sustained attention and other cognitive functions in children have rapidly increased. Two broad approaches for improving attention have been identified: cognitive attention training (brain training) and state training.

Cognitive attention training involves the repetitive practice of cognitive tasks which require sustained effort. It is thought that the repeated engagement in such tasks exercises neural networks related to attention. There are various programmes aimed at children, including some commercial products such as Tali Train and BrainTrain. Typically, training requires children to practise videogame-like attention tasks (among other tasks) delivered via computers or tablets, with different performance levels and reward systems to encourage motivation.

In contrast, meditation (in this case, mindfulness) and physical activity are types of ‘state training’. These are designed to develop a brain state that is thought to positively influence attention, getting young people into the right frame of mind to focus on a task.

Contrary to what we might see in the media, the systematic review showed that, in general, cognitive attention training does not reliably improve performance. Physical activity and meditation interventions demonstrated greater potential in enhancing sustained attention, but results were not conclusive.

Dr Slattery found that mindfulness training had consistent positive effects on a type of attention called ‘selective attention’. This is our ability to select one piece of information (such as the sound of a teacher’s voice) from our environment, whilst ignoring other things that are going on. It is likely that mindfulness targets many of the interacting features that determine our ability to pay attention, including our cognitive attention system, our levels of physiological arousal (which need to be neither too high nor too low for optimal concentration) and our emotional state. Physical activity also likely targets sustained attention via physiological arousal factors and cognitive control.

It’s important to note that none of the reviewed physical activity or mindfulness studies included a follow-up testing occasion. As a result, it is unclear whether the interventions produce long-lasting effects. The potential benefits of physical activity and meditation interventions need to be investigated in further, more rigorous, research.

Implications

“We found limited evidence that it is possible to train children’s ability to sustain attention”. 

Implications for schools – Given the current evidence, any programme which claims to benefit sustained attention should be treated with caution and educators should be aware that claims of efficacy may not be evidence-based. The findings of this review indicate that school staff should not assume that these three intervention types will reliably improve children’s sustained attention, and in particular, should be wary of cognitive attention training programmes. More research is also required to assess potential benefits of mindfulness and physical activity. 

Dr Slattery stresses the importance of being research informed. When evaluating the claims of any intervention, try to establish if there was a control group in the study and check the sample size – generally, the larger, the better. Schools should carefully monitor and evaluate the impact of any intervention they choose to use.

Implications for parents – Remember that all children are different and paying attention to what works for your child is important. More research also needs to be carried out to find out what can improve sustained attention at home. However, there is some evidence that ‘self-alert’ training can have a positive impact on boosting attention in the moment. Listen to our interview with Dr Slattery to find out more!

Resources Created from and Related to this Research

Dr Éadaoin Slattery, Post-doctoral Researcher in the Centre for Assessment Research, Policy and Practice in Education, Dublin City University

Dr Éadaoin Slattery currently works as a post-doctoral researcher in the Centre for Assessment Research, Policy and Practice in Education at Dublin City University. Her post-doctoral research focuses on game-based learning and assessment. She is broadly interested in the measurement and enhancement of cognition and behaviour, with a particular emphasis on attention and memory. Éadaoin holds a B.Sc. in Psychology and M.Sc. in Psychological Science from the University of Limerick. Her PhD research (also completed at the University of Limerick), which was funded by the Irish Research Council, focused on the development and evaluation of a school-based attention training programme designed to improve concentration in primary school children. Éadaoin is passionate about conducting meaningful scientific research which translates into real world impact. 

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