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The Role of Age, Cognitive Ability, and ADHD Symptoms on Outcomes of Attention Training in Primary School Children

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The Role of Age, Cognitive Ability, and ADHD Symptoms on Outcomes of Attention Training in Primary School Children

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Attention training can improve children’s attention; however, certain child characteristics may influence differential outcomes. This study explored the influence of age, general cognitive ability, and ADHD symptoms on attention outcomes following attention training. Ninety-eight children (5–9 years) were randomized to participate in attention training, placebo, or usual school activities for 20 min daily during class over 5 weeks. Child cognitive assessments and parent/teacher behavioral questionnaires were completed pre-, post-, and 6 month post-intervention. Linear mixed-effects models indicated that for the attention training condition, younger age was associated with greater improvement in cognitive attention post-intervention and older age with less improvement, while more ADHD symptoms were associated with greater reductions in teacher-rated inattentive/hyperactive behavior post-intervention and fewer ADHD symptoms were associated with fewer improvements in cognitive attention post-intervention. General cognitive ability was not associated with outcomes. Child characteristics may influence attention training outcomes; however, larger studies are needed.
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https://doi.org/10.1007/s41465-021-00229-0
ORIGINAL RESEARCH
The Role ofAge, Cognitive Ability, andADHD Symptoms onOutcomes
ofAttention Training inPrimary School Children
H.E.Kirk1 · S.Richmond1· K.M.Cornish1· M.Spencer‑Smith1
Received: 5 July 2021 / Accepted: 15 October 2021
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
Abstract
Attention training can improve children’s attention; however, certain child characteristics may influence differential outcomes.
This study explored the influence of age, general cognitive ability, and ADHD symptoms on attention outcomes following
attention training. Ninety-eight children (5–9years) were randomized to participate in attention training, placebo, or usual
school activities for 20min daily during class over 5weeks. Child cognitive assessments and parent/teacher behavioral
questionnaires were completed pre-, post-, and 6month post-intervention. Linear mixed-effects models indicated that for the
attention training condition, younger age was associated with greater improvement in cognitive attention post-intervention
and older age with less improvement, while more ADHD symptoms were associated with greater reductions in teacher-rated
inattentive/hyperactive behavior post-intervention and fewer ADHD symptoms were associated with fewer improvements
in cognitive attention post-intervention. General cognitive ability was not associated with outcomes. Child characteristics
may influence attention training outcomes; however, larger studies are needed.
Keywords Attention· Cognitive training· Individual differences· Inattention· Hyperactivity
Digital attention training programs have garnered inter-
est to improve aspects of attention performance for clini-
cal child populations (Kirk etal., 2016, 2017; Shalev etal.,
2007; Steiner etal., 2011; Tamm etal., 2013), as well as
typically developing children (Kirk etal., 2021). There is
evidence that attention training can improve aspects of chil-
dren’s attention in the short-term (Kirk etal., 2016, 2021;
Tamm etal., 2013), but not all studies report these benefits
(Bikic etal., 2018; Moore etal., 2018; Steiner etal., 2014).
Reviews (Simons etal., 2016; Rossignoli-Palomeque etal.,
2018) and meta-analyses (Sala & Gobet, 2017; Sala etal.,
2019) suggest inconsistent findings across cognitive training
studies may reflect methodological limitations such as using
a non-randomized design and no long-term follow-ups, as
well as differences in interventions such as the skill targeted
and the training dose (Scionti etal., 2020). Evidence from
meta-analyses and a few small sample cognitive training
studies suggest child characteristics, such as age (Peng &
Miller, 2016; Sala & Gobet, 2017; Sala etal., 2019; Tamm
etal., 2013), general cognition (Gathercole etal., 2019; Jae-
ggi etal., 2014), and clinical status (Peng & Miller, 2016;
Scionti etal., 2020; van der Donk etal., 2016), may influ-
ence training outcomes. Although child characteristics may
influence outcomes of attention training (Kirk etal., 2020;
Peng & Miller, 2016), and therefore be useful markers to
assist in predicting potential benefits prior to training com-
mencement, to date, this has not been examined in typically
developing children.
Initial evidence from a meta-analysis of attention train-
ing studies in adults and children (n = 15, age range 4.35
to 84.5years (Peng & Miller, 2016)) showed that age sig-
nificantly moderated the effect of training on both subjec-
tive (teacher, researcher, or parent ratings/interviews) and
objective measures (computerized cognitive assessments;
r2 = 0.42) of attention. Specifically, younger age was asso-
ciated with greater benefits of attention training. One study
to date that has examined the association between child
characteristics and attention training outcomes in children
diagnosed with Attention Deficit Hyperactivity Disorder
(ADHD; n = 105, 7–15years) showed that older age (but
not general cognitive ability, ADHD subtype, medication
status or gender) moderated the effect of attention training
* H. E. Kirk
hannah.kirk@monash.edu
1 School ofPsychological Sciences, Turner Institute forBrain
andMental Health, Monash University, Melbourne,
Australia
/ Published online: 22 October 2021
Journal of Cognitive Enhancement (2022) 6:170–182
1 3
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