Popular interventions to enhance sustained attention in children and adolescents: A critical systematic review

There are a myriad of interventions promoting activities designed to help enhance sustained attention in children and adolescents. In this systematic review, we critically evaluate the evidence behind three popular sustained attention training approaches - cognitive attention training, meditation, and physical activity. Seven databases were searched in addition to secondary searches. Cognitive attention training, meditation training or physical activity intervention studies aimed at improving sustained attention (randomised-controlled or non-randomised-controlled designs) in samples of children and adolescents (3-18 years) were included. We screened 3437 unique articles. Thirty-seven studies satisfied inclusion criteria. In general, cognitive attention training (n = 14) did not reliably improve sustained attention. Physical activity (n = 15) and meditation interventions (n = 8) demonstrated somewhat more potential in enhancing sustained attention, but these effects should be considered preliminary and need to be replicated with greater methodological rigour. Cognitive attention training demonstrated very limited transfer to other aspects of attention. Notably, mindfulness training had rather consistent positive effects on selective attention. Across all three intervention types, there was very weak evidence for transfer to other aspects of cognition, behaviour, and academic achievement. The paper concludes with methodological recommendations for future studies to strengthen the evidence base.