Cognitive rehabilitation: A method for improving sustained and selective attention in adolescents with attentional deficits

Attention Deficit Disorder (ADD) is an inherited neuropsychological disorder affecting 3% to 5% of the school-aged population of the United States and having no identified single cause. The primary treatment recommended for those suffering from attentional deficits is multimodal, which includes psychostimulant medication in the form of methylphenidate (Ritalin) and behavioral/educational interventions. However, there is a subset of sufferers who, though taking psychostimulant medications and undergoing behavioral and educational interventions, continue to suffer the symptoms of attentional deficits: distractibility, impulsiveness and aggressive behavior; Those affected by acquired brain injuries as the result of some external trauma or neurological disorder suffer the same symptoms of attentional deficits as those diagnosed with ADD. As a treatment, a process called cognitive rehabilitation is implemented to remediate or improve these deficits, allowing the subjects to regain preinjury level information processing. The primary approach to cognitive rehabilitation is attention process training using computers; The purpose of this study was to determine the effectiveness of cognitive rehabilitation as a method of improving the sustained and selective attention of four (4) male middle-school students with diagnosed childhood attention deficit disorder and who were being treated with psychostimulant medications. Using a correlated sample, pretest-posttest design, the subjects were pretested to determine current levels of attentional functioning and posttested after exposure to a hierarchical attention training program, which included three weeks of sustained attention training and three-weeks of selective attention training. The results were mixed. All four subjects experienced some improvement in sustained and selective attentional functioning from pretest to posttest on at least two of the three measures of attention. However, only the selective attention results were significant. This indicates that cognitive rehabilitation could be an effective intervention strategy in the treatment of ADD and further study and replication are warranted with a change to a two-group comparison pr multiple baseline design