Failures of sustained attention in life, lab, and brain: ecological validity of the SART

The Sustained Attention to Response Task (SART) is a widely used tool in cognitive neuroscience increasingly employed to identify brain regions associated with failures of sustained attention. An important claim of the SART is that it is significantly related to real-world problems of sustained attention such as those experienced by TBI and ADHD patients. This claim is largely based on its association with the Cognitive Failures Questionnaire (CFQ), but recently concerns have been expressed about the reliability of the SART-CFQ association. Based on a review of the literature, meta-analysis of prior research, and analysis of original data, we conclude that, across studies sampling diverse populations and contexts, the SART is reliably associated with the CFQ. The CFQ-SART relation also holds for patients with TBI. We note, however, conceptual limitations of using the CFQ, which was designed as a measure of general cognitive failures, to validate the SART, which was specifically designed to assess sustained attention. To remedy this limitation, we report on associations between the SART and a specific Attention-Related Cognitive Errors Scale (ARCES) and a Mindful Awareness of Attention Scale-Lapses Only (MAAS-LO).