Keeping score!: The development and evaluation of a school-based attention training programme for children with attentional difficulties

Sustained attention is fundamental for effective learning and functioning. Currently, there is no cognitive attention training programme used in schools to enhance sustained attention in children. This project aims to develop and evaluate a training programme that can be used by school personnel to enhance sustained attention in children. Training is based on sustained updating, which capitalises on the interplay between sustained attention and working memory. This thesis consists of four inter-related empirical studies and a systematic review. Study 1A investigated the relationship between sustained attention and working memory in the context of their contribution to children’s reading achievement. The results indicated that (a) working memory, but not sustained attention, made unique contributions to the prediction of reading achievement, and (b) any variance sustained attention explained in reading achievement, albeit small in magnitude, was through shared variance with other predictors. Study 1B examined the relationship between sustained attention and working memory in the context of their contribution to children’s inattentive behaviour. The results suggested that (a) sustained attention uniquely explained a substantial proportion of variance in inattentive behaviour, (b) working memory explained a small amount of unique variance in inattentive behaviour, and (c) working memory mostly accounted for variance in inattentive behaviour via shared variance with sustained attention. Study 2 evaluated the sustained updating training mechanism implemented in small group format in children with lower attentional ability using a cluster-randomised design. The results provided no evidence of statistically significant improvements in students’ sustained attention capacity, working memory capacity or parent ratings of executive function. Study 3 evaluated the training mechanism implemented in a one-to-one format for children with ADHD using single case methodology. The findings suggested that the training did not improve children’s sustained attention capacity, working memory capacity or executive function behaviour. Study 4 was a systematic review of popular attention training interventions (cognitive attention training, meditation training and physical activity) specifically targeting sustained attention enhancement in children and adolescents. The results indicated that in general cognitive attention training did not reliably improve sustained attention; however, physical activity and mindfulness interventions demonstrated somewhat more potential. Overall, this thesis advances our understanding of sustained attention malleability in children. It suggests that substantially altering children’s sustained attention using cognitive training methods is extremely difficult and casts doubt on whether this type of training is a viable intervention for sustained attention enhancement.